Individual
DR. JONATHAN BRAD EGBERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1055 N 500 W, PROVO, UT 84604-3305
(801) 354-8225
(801) 418-0941
Mailing address
1055 N 500 W, ATTN CREDENTIALING, PROVO, UT 84604-3305
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
CHIA1449
ID
207Q00000X
Family Medicine Physician
098-T2
WY
207Q00000X
Family Medicine Physician
Primary
14271352-1205
UT
207Q00000X
Family Medicine Physician
Primary
MD193108
OR
Other
Enumeration date
03/09/2011
Last updated
05/15/2026
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