Individual
KYLE HAROLD JASPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
324 TENTH AVE STE 178, SALT LAKE CITY, UT 84103-2885
(801) 408-8502
Mailing address
PO BOX 3369, PORTLAND, OR 97208-3369
(866) 747-2455
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
12046591-1205
UT
2084P0800X
Psychiatry Physician
A184429
CA
2084P0800X
Psychiatry Physician
Primary
MD61448848
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/03/2017
Last updated
11/16/2023
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