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Individual

JAMES EVERRET TOLLEFSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
4403 HARRISON BLVD STE 3490, OGDEN, UT 84403-3284
(801) 387-2650
(801) 387-2655
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
34.013222
OH
207RC0000X
Cardiovascular Disease Physician
Primary
12925049-1204
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0445026
OH
Enumeration date
04/09/2016
Last updated
04/22/2024
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