Individual
JASON EATOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
331 N 400 W, OREM, UT 84057-1913
(801) 714-3200
(801) 714-3201
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 714-3200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
319284-1206
UT
363AM0700X
Medical Physician Assistant
PA509
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806997400
—
ID
Enumeration date
06/03/2006
Last updated
09/22/2023
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