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Dr. J. Bryan Ellsworth, MD
Specialist in St George, Utah
NPI 1083619043

J. Bryan Ellsworth is a Specialist based in St George, UT. J. Bryan Ellsworth practices in St George, UT and has the professional credentials of MD. The NPI Number for J. Bryan Ellsworth is 1083619043 and holds a License No. 15297 (Utah).

The current practice location address for J. Bryan Ellsworth is 736 S 900 E Ste 108, St George, UT and can be reached out via phone at 435-628-3606 and via fax at 435-628-8404.

Location: 736 S 900 E Ste 108, St George, UT, 84790-7002
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1083619043
Provider Name
J. Bryan Ellsworth
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
736 S 900 E Ste 108, St George, UT, 84790-7002
Phone Number
435-628-3606
Fax Number
435-628-8404
Provider Enumeration Date
06/16/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
005575530 01 UT HUMANA
6411882 01 UT CIGNA
751575 01 UT DMBA
870562879ELL 01 UT EMIA
V108245 01 NV MEDICARE ID FOR NEVADA PRACTICE LOCATION
68471 01 UT PEHP
18855012000001 01 UT BC BS
340020123 01 UT RR MEDICARE
107011798101 01 UT IHC
QM0000076522 01 UT ALTIUS
institution
Provider Business Practice Location Address Details
Address
736 S 900 E Ste 108
City
St George
State
Utah
Zip
84790
Phone Number
435-628-3606
Fax Number
435-628-8404
person
Provider Business Mailing Address Details
Address
736 S 900 E Ste 108
City
St George
State
Utah
Zip
84790
Phone Number
435-628-3606
Fax Number
435-628-8404
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
188550-1205 (Utah)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Urology
Speciality
-
Taxonomy
208800000X
License No.
15297 (Nevada)
Definition
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
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