Individual
JOHN EVAN THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
30 N 1900 E RM 3B420, SALT LAKE CITY, UT 84132-0002
(801) 213-2700
(801) 585-2891
Mailing address
848 E 750 N, BOUNTIFUL, UT 84010-2853
(801) 821-3649
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
10403324-8906
UT
363A00000X
Physician Assistant
10403324-1206
UT
363AS0400X
Surgical Physician Assistant
Primary
10403324-1206
UT
Other
Enumeration date
08/25/2017
Last updated
12/20/2021
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