Individual
ERIC JONATHAN ROOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
355 N MAIN ST, KANAB, UT 84741
(435) 644-4100
(435) 644-3366
Mailing address
1055 N 500 W, ATTN: CREDENTIALING, PROVO, UT 84604-3305
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10875819-1204
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
AZ
Other
Enumeration date
05/01/2015
Last updated
11/27/2023
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