MEDICARE: JEFFREY DELOS LINTON P.A.

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	363AS0400X	Surgical Physician Assistant	285233-1206	UT
2	363A00000X	Physician Assistant	285233-1206	UT

General Provider Information

NPI Number	:	1649219775
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY DELOS LINTON P.A.

Provider Business Mailing Address
First Line	:	PO BOX 581700
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84158-1700
Country	:	US
Telephone Number	:	801-587-6454
Fax Number	:	801-587-6459

Provider Business Practice Location Address
First Line	:	1950 CIRCLE OF HOPE DR
Second Line	:	SUITE 2810
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84112-5500
Country	:	US
Telephone Number	:	801-587-4386
Fax Number	:	801-585-0155

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

Provider Enumeration Date	:	06/05/2006
Last Update Date	:	12/27/2021

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