Individual
JEAN F BOTHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5171 S COTTONWOOD ST STE 210, MURRAY, UT 84107-5718
(801) 507-3380
(801) 507-8343
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 507-3380
(801) 507-8343
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
12742339-1205
UT
204F00000X
Transplant Surgery Physician
22313
NE
208600000X
Surgery Physician
Primary
12742339-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47078557580
—
NE
Enumeration date
04/28/2006
Last updated
06/15/2026
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