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Individual

JOHN ROBERT SHAKULA

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
9720 S 1300 E, W120, SANDY, UT 84094-3712
(801) 571-0423
(801) 571-0081
Mailing address
12801 BOULTER ST, DRAPER, UT 84020-9134
(801) 571-0423
(801) 571-0081

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
1574601205
UT

Other

Enumeration date
06/07/2006
Last updated
07/08/2007
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