Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 7277593-1205 | UT |
NPI | 1053565978 |
---|---|
Provider Name | Dr. Jaron Thaddeus Abbott |
First Address | Salt Lake City, UT 84127-0128 |
Second Address | Provo, UT 84604-6124 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/11/2008 |
Last Update Date | 29/09/2021 |