Individual
JARED ALAN JOHNSTUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
623 E FORT UNION BLVD STE 105, MIDVALE, UT 84047-5529
(385) 412-1660
Mailing address
623 E FORT UNION BLVD STE 105, MIDVALE, UT 84047-5529
(385) 412-1660
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
8134352-1205
UT
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
036.160773
IL
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
8134352-1205
UT
207RP1001X
Pulmonary Disease Physician
036.160773
IL
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/15/2011
Last updated
08/22/2024
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