MEDICARE: DR. JORDAN RUSSELL ROBERTS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	9897039-1205	UT

General Provider Information

NPI Number	:	1588043871
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JORDAN RUSSELL ROBERTS M.D.

Provider Business Mailing Address
First Line	:	999 E MURRAY HOLLADAY RD STE 207
Second Line	:
City	:	HOLLADAY
State	:	UT
Zip	:	84117-5093
Country	:	US
Telephone Number	:	801-268-2584
Fax Number	:	801-262-1168

Provider Business Practice Location Address
First Line	:	999 E MURRAY HOLLADAY RD STE 207
Second Line	:
City	:	HOLLADAY
State	:	UT
Zip	:	84117-5093
Country	:	US
Telephone Number	:	801-268-2584
Fax Number	:	801-262-1168

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2015
Last Update Date	:	09/15/2018

Similar Medicare Providers

1205820693 — DR. RICHARD B GREMILLION MD
Practice Location Address:

999 E MURRAY HOLLADAY RD STE 207
MILLCREEK, UT
84117-5093

Practice Phone: 801-965-3600
Practice Fax:

1609037779 — DR. BRUCE A. PYPER DMD
Practice Location Address:

999 E MURRAY HOLLADAY RD STE 205
SALT LAKE CITY, UT
84117-5093

Practice Phone: 801-277-8233
Practice Fax:

1558941583 — JOSHUA R LLOYD DO
Practice Location Address:

999 E MURRAY HOLLADAY RD STE 207
MILLCREEK, UT
84117-5093

Practice Phone: 801-965-3600
Practice Fax:

1154003473 — STACEY MILLS LAKE NP
Practice Location Address:

999 E MURRAY HOLLADAY RD STE 207
HOLLADAY, UT
84117-5093

Practice Phone: 801-268-2584
Practice Fax:

1225971880 — JILLIAN BRINTON COTA/L
Practice Location Address:

4782 S HOLLADAY BLVD
HOLLADAY, UT
84117-5444

Practice Phone: 801-277-7002
Practice Fax:

1295735728 — DR. JAYNE ELIZABETH CLARK M.D.
Practice Location Address:

2180 E 4500 S , SUITE #185
HOLLADAY, UT
84117-4434

Practice Phone: 801-272-6972
Practice Fax: 801-272-6953

Directions to “ DR. JORDAN RUSSELL ROBERTS M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.