Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207W00000X | Ophthalmologist | 1352-TEP | WI |
Y | 207WX0107X | Retina Specialist | 7161573-1205 | UT |
NPI | 1023073459 |
---|---|
Provider Name | Jonathan B Gunther |
First Address | Provo, UT 84604-1010 |
Second Address | Provo, UT 84604 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2006 |
Last Update Date | 28/06/2018 |