Healthcare Provider Details

I. General information

NPI: 1215720511
Provider Name (Legal Business Name): HUNTER PARDUHN PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2025
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1248 E 90 N # 300
AMERICAN FORK UT
84003-2956
US

IV. Provider business mailing address

6078 W 10930 N
HIGHLAND UT
84003-9562
US

V. Phone/Fax

Practice location:
  • Phone: 801-756-9635
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: