Healthcare Provider Details

I. General information

NPI: 1235299561
Provider Name (Legal Business Name): RODNEY M. JEX DPM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 MEDICAL DR STE 215
BOUNTIFUL UT
84010-4945
US

IV. Provider business mailing address

425 MEDICAL DR STE 215
BOUNTIFUL UT
84010-4945
US

V. Phone/Fax

Practice location:
  • Phone: 801-292-9222
  • Fax: 801-298-3987
Mailing address:
  • Phone: 801-292-9222
  • Fax: 801-298-3987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number22-102019-0501
License Number StateUT

VIII. Authorized Official

Name: DR. RODNEY M. JEX
Title or Position: OWNER
Credential: DPM
Phone: 801-292-9222