Individual
JONATHAN ANDREW HARTSHORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
395 W COUGAR BLVD STE 801, PROVO, UT 84604-3311
(801) 229-1054
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
2084E0001X
Epilepsy Physician
Primary
12127629-1205
UT
2084N0400X
Neurology Physician
12127629-1205
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/18/2016
Last updated
11/21/2024
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