# JOLLEY PHYSICIAN SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124420492
- **Authorized official:** MR. MICHAEL B JOLLEY MD (OWNER)
- **Authorized official phone:** (323) 803-8480

## Contact information

- **Practice address:** 355 S PALISADES DR, OREM, UT 84097-5739
- **Practice address phone:** (323) 803-8480
- **Mailing address:** 355 S PALISADES DR, OREM, UT 84097-5739
- **Mailing address phone:** (323) 803-8480

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/18/2014
- **Last updated:** 03/26/2015