Individual
DR. JESSE ELLSWORTH RILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
41 N 400 W STE A, PAYSON, UT 84651-2021
(801) 218-3338
(801) 658-5351
Mailing address
41 N 400 W STE A, PAYSON, UT 84651-2021
(801) 218-3338
(801) 658-5351
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
90377690501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
90377690501
LICENSE
UT
Enumeration date
02/07/2012
Last updated
03/07/2023
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