Individual
DR. JONATHAN CHARLES ROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
950 MEDICAL DR, BRIGHAM CITY, UT 84302-4724
(435) 734-9471
Mailing address
PO BOX 629, OGDEN, UT 84402-0629
(580) 536-9300
(580) 539-7900
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
19785
OK
2085R0202X
Diagnostic Radiology Physician
Primary
5571577-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100207220C
—
OK
01
—
243328301
INDIVIDUAL MEDICARE NUMBE
OK
Enumeration date
07/26/2005
Last updated
07/18/2018
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