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Individual

JONATHAN ROBERT GENZEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD, PHD

Contact information

Practice address
500 CHIPETA WAY, MAIL CODE: 115, SALT LAKE CITY, UT 84108
(801) 583-2787
(801) 584-5207
Mailing address
500 CHIPETA WAY, MAIL CODE: 115, SALT LAKE CITY, UT 84108
(801) 583-2787
(801) 584-5207

Taxonomy

Speciality
Code
Description
License number
State
207ZC0006X
Clinical Pathology Physician
Primary
8483431-1205
UT
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
253078
NY
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
8483431-1205
UT
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
8483431-1205
UT

Other

Enumeration date
05/22/2009
Last updated
08/30/2023
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