Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Phillip Fairbourn, MD

Individual provider Diagnostic Radiology Physician · NPI 1801182357

Dr. Phillip Fairbourn, MD is a Diagnostic Radiology in St George, Utah. Graduated from Medical College of Wisconsin in 2011, 15 years ago. Practices with Revere Health PC, a 410-clinician group, works from 6 locations and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
15
Trained at
Medical College of Wisconsin
Licensed in
UT
In the registry since
2011
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2825 E Mall Dr
St George, UT 84790-1954
Phone: (435) 986-2238
Fax: (435) 986-2237
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (5)

  • 1175 E 50 S Ste 141, American Fork, UT 84003-2845 — (801) 492-5996
  • 3000 N Triumph Blvd Ste 100, Lehi, UT 84043-4999 — (801) 812-4624
  • 1055 N 500 W Ste 112, Provo, UT 84604-3305 — (801) 812-4624
  • 555 W Sr 164, Salem, UT 84653 — (801) 812-4624
  • 2825 E Mall Dr, St George, UT 84790-1954 — (435) 986-2238

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence 10800395-1205 (UT)

Record details

NPI number1801182357
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 23, 2011
Last updated in NPPESMarch 25, 2025
Certification dateMarch 25, 2025
Mailing address1055 N 500 W, Attn Credentialing, Provo, UT 84604-3305

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolMEDICAL COLLEGE OF WISCONSIN
Graduated 2011 (15 years in practice)
Group practice Revere Health Pc — 410 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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