Individual
JAYME EATOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5373 S GREEN ST STE 400, SALT LAKE CITY, UT 84123-4740
(801) 442-5502
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10654521-1206
UT
363A00000X
Physician Assistant
10654521-8906
UT
363A00000X
Physician Assistant
PA.0005502
CO
Other
Enumeration date
01/09/2018
Last updated
06/01/2023
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