Individual
JON WILLARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
170 N 1100 E, AMERICAN FORK, UT 84003-2096
(801) 855-4650
Mailing address
170 N 1100 E, AMERICAN FORK, UT 84003-2096
(801) 855-4650
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
070013
GA
207P00000X
Emergency Medicine Physician
Primary
9463450-1204
UT
207P00000X
Emergency Medicine Physician
OT012855
PA
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
070013
GA
Other
Enumeration date
05/20/2009
Last updated
07/28/2022
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