Individual
TYSON R. JERGENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0001
(801) 581-3622
Mailing address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0001
(801) 581-3622
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
12404285-1205
UT
Other
Enumeration date
04/03/2020
Last updated
03/09/2025
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