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Individual

JASON MARSHALL ALLEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1055 N 500 W STE 112, PROVO, UT 84604-3305
(801) 812-4624
(801) 812-4699
Mailing address
1055 N 500 W, PROVO, UT 84604-3305
(801) 354-8225
(801) 418-0941

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
14261150-1204
UT
2085R0202X
Diagnostic Radiology Physician
DR.0054989
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
94920869
CO
Enumeration date
05/02/2007
Last updated
03/26/2026
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