Healthcare Provider Details

I. General information

NPI: 1952343402
Provider Name (Legal Business Name): JARED LON SZYMANSKI DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 06/16/2021
Certification Date: 06/16/2021
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: 501-500-6640
  • Fax:
Mailing address:
  • Phone: 501-500-6640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License Number70696181204
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License Number70696181204
License Number StateUT
# 3
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number70696181204
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: