Individual
DR. JEDIDIAH DUNBAR OLDHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
97 PROFESSIONAL WAY STE 2, PAYSON, UT 84651-1680
(801) 465-4896
(801) 465-4107
Mailing address
1055 N 500 W, ATTN: CREDENTIALING, PROVO, UT 84604
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11197222-1204
UT
208600000X
Surgery Physician
5101020701
MI
390200000X
Student in an Organized Health Care Education/Training Program
58976
MT
Other
Enumeration date
06/18/2013
Last updated
11/27/2023
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