Individual
DR. BENJAMIN RAY ELIASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1654 W REUNION AVE STE 10B, SOUTH JORDAN, UT 84095-4676
(801) 349-2480
(801) 363-4885
Mailing address
10471 S ALEXANDER PARK LN, SOUTH JORDAN, UT 84095-3121
(541) 678-3697
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
10366261-1205
UT
2084P0800X
Psychiatry Physician
10366261-8905
UT
2084P0800X
Psychiatry Physician
75589
MN
2084P0800X
Psychiatry Physician
MD125756
OR
261Q00000X
Clinic/Center
MD125756
OR
Other
Enumeration date
01/31/2007
Last updated
11/13/2023
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