Individual
MR. FANTLEY F JONES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
237 26TH ST, OGDEN, UT 84401-3105
(801) 625-3700
Mailing address
237 26TH STREET, OGDEN, UT 84401
(801) 334-8770
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
260022408
RAILROAD MEDICARE
UT
05
—
876000308007
—
UT
Enumeration date
03/11/2011
Last updated
03/11/2011
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