Individual
JARED A GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1870 N MAIN ST STE 201, CEDAR CITY, UT 84721-7742
(435) 383-9009
(435) 383-9010
Mailing address
1055 NORTH 500 WEST ATTN: CREDENTIALING, PROVO, UT 84604-3305
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8441754-1206
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
067405
—
AZ
Enumeration date
03/17/2006
Last updated
03/25/2025
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