Healthcare Provider Details

I. General information

NPI: 1093945537
Provider Name (Legal Business Name): JARED L SZYMANSKI DO PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2009
Last Update Date: 05/14/2021
Certification Date: 05/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2889 W ASHTON BLVD STE 300
LEHI UT
84043-4968
US

IV. Provider business mailing address

5100 TALLEY RD STE 300
LITTLE ROCK AR
72204-8040
US

V. Phone/Fax

Practice location:
  • Phone: 15-006-6405
  • Fax: 501-500-6681
Mailing address:
  • Phone: 501-500-6640
  • Fax: 15-006-6405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License Number6590867-1205
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License Number6590867-1205
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number6590867-1205
License Number StateUT
# 4
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number6590867-1205
License Number StateUT

VIII. Authorized Official

Name: DR. JARED L SZYMANSKI
Title or Position: PRESIDENT
Credential: DO
Phone: 801-225-5407