Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 5353571-1205 | UT |
NPI | 1033209614 |
---|---|
Provider Name | Eliot Ashby Brinton |
First Address | Bountiful, UT 84011-0268 |
Second Address | Salt Lake City, UT 84108-1244 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 06/02/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1033209614 | (05) | UT |