Individual
JASON JON NAKKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3585 N UNIVERSITY AVE STE 105, PROVO, UT 84604-6601
(801) 356-6100
Mailing address
3585 N UNIVERSITY AVE STE 105, PROVO, UT 84604-6601
(801) 356-6100
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
11085893-1204
UT
207L00000X
Anesthesiology Physician
BP1-0050303
TX
208VP0014X
Interventional Pain Medicine Physician
Primary
11085893-1204
UT
Other
Enumeration date
06/19/2014
Last updated
08/14/2019
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