Devin Bradley Despain, D.O.
Individual provider Active NPI Anesthesiology Physician · Perry, UT
NPI 1144306176 · NPPES record last updated Oct 8, 2013
Key facts
- NPI
- 1144306176
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anesthesiology Physician 207L00000X
- License
- UO1077 (FL)
- Practice address
- 1885 S 250 W
Perry, UT 84302-4544 - Phone
- (435) 553-5305
- NPI assigned
- Oct 31, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| UO1077 | FL | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brigham Anesthesia, LLC | Anesthesiology | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | UO1077 | FL | Yes |
Addresses
Primary practice location
1885 S 250 W
Perry, UT 84302-4544
Mailing address
1885 S 250 W
Perry, UT 84302-4544
Phone (435) 553-5305
Other providers in Perry, UT
- Karen D Barnes
- Timothy Arthur Briggs
- Angela Miles Carter
- Comforts of Home, Inc.
- Bryan M Dana
- Aaron F Gardner
- Goble Medical Group
- Sarah Michelle Bruder Gougler-Fletcher
- Grizzly Peak Assisted Living, LLC
- Ava Hanson
All providers in Perry, UT · Anesthesiology Physician in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 8, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.