Individual
JONATHAN FOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
630 MEDICAL DR, BOUNTIFUL, UT 84010-4908
(801) 299-2155
Mailing address
PO BOX 742353, ATLANTA, GA 30374-2353
(801) 771-7771
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
7127109-4405
UT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
7127109-4405
UT
Other
Enumeration date
10/27/2022
Last updated
01/31/2023
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