Individual
JON LAWSON LANDEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
719 W 400 N, MOAB, UT 84532-2239
(435) 259-7191
Mailing address
400 E 10TH ST, WACONIA, MN 55387-4552
(952) 442-9770
(952) 442-3630
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
1522641205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04295
—
UT
Enumeration date
04/12/2006
Last updated
04/29/2008
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