Individual
JEFFREY DWIGHT UPTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1525 VISTA LN, 120, CARSON CITY, NV 89703-4633
(775) 885-9991
(775) 883-0884
Mailing address
1525 VISTA LN, STE 120, CARSON CITY, NV 89703-4633
(775) 885-9991
(775) 883-0884
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
5645
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20-13007
—
NV
Enumeration date
03/22/2006
Last updated
02/03/2012
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