Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 52129531205 | UT |
NPI | 1003823808 |
---|---|
Provider Name | Jared C Dunn |
First Address | Salt Lake City, UT 84107-6121 |
Second Address | Salt Lake City, UT 84107-6121 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2006 |
Last Update Date | 14/10/2014 |