Individual
JEFFREY DAVID POULSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1034 N 500 W, PROVO, UT 84604-3380
(801) 357-7850
Mailing address
3340 N CENTER ST # 800, LEHI, UT 84043-7406
(801) 990-1911
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
7656910-1205
UT
207L00000X
Anesthesiology Physician
Primary
MD222767
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/10/2009
Last updated
06/04/2025
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