Individual
JONATHAN TAYLOR WHITAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3723 W 12600 S, RIVERTON, UT 84065-7295
(801) 507-4384
(801) 507-4398
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
13716859-1204
UT
207R00000X
Internal Medicine Physician
SL1023
NV
Other
Enumeration date
05/13/2014
Last updated
04/23/2024
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