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Individual
MR. JEROMY RON MENDENHALL
Active
Individual
MR. JEROMY RON MENDENHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
7106674-1206
UT
363A00000X
Physician Assistant
Primary
PA1131
NV
363AS0400X
Surgical Physician Assistant
7106674-1206
UT
363AS0400X
Surgical Physician Assistant
PA1131
NV
Other
Enumeration date
07/15/2008
Last updated
08/06/2024
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