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Individual

JORDAN TALMAGE HUBER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1350 N 500 E, LOGAN, UT 84341-2400
(435) 716-1770
Mailing address
PO BOX 27128, SLC, UT 84127-0128
(435) 716-1770

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
11659150-1205
UT
207R00000X
Internal Medicine Physician
57079
AZ

Other

Enumeration date
05/11/2017
Last updated
11/17/2021
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