Individual
DR. MARK JONATHAN DEVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
672 W. 400 S., SUITE 101, SPRINGVILLE, UT 84663
(801) 491-9883
(801) 489-3141
Mailing address
1055 N 500 W, ATT. CREDENTIALING, PROVO, UT 84604
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
340404-1205
UT
Other
Enumeration date
05/15/2006
Last updated
10/11/2023
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