Individual
DR. JEREMY C STARR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1515 N 400 E STE 104, NORTH LOGAN, UT 84341-7595
(435) 755-6061
Mailing address
517 W 100 N STE 210, PROVIDENCE, UT 84332-9826
(435) 755-6061
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
6842A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118894100
—
WY
01
—
313768
BLUE CROSS/BLUE SHIELD
WY
Enumeration date
09/26/2006
Last updated
07/11/2019
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