Individual
ALLAN JEFFERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1055 N 500 W, SUITE 212, PROVO, UT 84604-3305
(801) 374-2362
(801) 429-8196
Mailing address
1055 N 500 W, CREDENTIALING DEPARTMENT, PROVO, UT 84604-3305
(801) 354-8215
(801) 429-8180
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5745854-1204
UT
Other
Enumeration date
11/16/2006
Last updated
07/08/2007
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