Individual
JEFFREY LYNN DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
389 S 900 E, SALT LAKE CITY, UT 84102-2310
(385) 282-2850
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(385) 282-2850
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8233732-1206
UT
363AM0700X
Medical Physician Assistant
5063
AZ
363AM0700X
Medical Physician Assistant
PA2012-0043
NM
Other
Enumeration date
11/02/2011
Last updated
01/20/2017
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