Healthcare Provider Details

I. General information

NPI: 1174937296
Provider Name (Legal Business Name): NATHAN M ESHENRODER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: NATHAN MICHAEL ESHENRODER M.D.

II. Dates (important events)

Enumeration Date: 06/17/2014
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 W LAYTON PKWY
LAYTON UT
84041-3692
US

IV. Provider business mailing address

3340 N CENTER ST STE 800
LEHI UT
84043-7794
US

V. Phone/Fax

Practice location:
  • Phone: 801-990-1911
  • Fax:
Mailing address:
  • Phone: 801-990-1911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number6739191-1205
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number01097978A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberLL37111
License Number StateSC
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberR4217
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: