Individual
MR. JORDAN TYLER FOULGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
12473 S MINUTEMAN DR, DRAPER, UT 84020-7870
(801) 495-7970
(801) 495-7990
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
13574229-1206
UT
363A00000X
Physician Assistant
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W238629531
AETNA
AZ
Enumeration date
09/29/2018
Last updated
03/01/2024
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