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Organization

JARED J TYSON MD PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANNETTE SIMMONS (OFFICE MANAGER)
(801) 295-7200
Entity
Organization

Contact information

Practice address
1551 RENAISSANCE TOWNE DR, SUITE 400, BOUNTIFUL, UT 84010-7667
(801) 295-7200
(801) 295-4930
Mailing address
1551 RENAISSANCE TOWNE DR, SUITE 400, BOUNTIFUL, UT 84010-7667
(801) 295-7200
(801) 295-4930

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
8915908-1205
UT

Other

Enumeration date
01/28/2015
Last updated
01/28/2015
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