Individual
JAYANT PRASAD AGARWAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
DIVISION OF PLASTIC SURGERY ADMINISTRATIVE OFFICE, 30 NORTH 1900 EAST 3B205, SALT LAKE CITY, UT 84132-0001
(801) 585-6839
(801) 581-5794
Mailing address
DIVISION OF PLASTIC SURGERY ADMINISTRATIVE OFFICE, 30 NORTH 1900 EAST 3B205, SALT LAKE CITY, UT 84132-0001
(801) 585-6839
(801) 581-5794
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
A93768
CA
Other
Enumeration date
08/12/2006
Last updated
10/16/2021
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