Healthcare Provider Details

I. General information

NPI: 1568754364
Provider Name (Legal Business Name): NATHAN W ASTON PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2011
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2825 E MALL DR
SAINT GEORGE UT
84790-1954
US

IV. Provider business mailing address

1055 N 500 W ATTN; CREDENTIALING
PROVO UT
84604-3305
US

V. Phone/Fax

Practice location:
  • Phone: 435-628-9393
  • Fax: 435-628-9382
Mailing address:
  • Phone: 801-354-8225
  • Fax: 801-418-0941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number7960348-1206
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number7960348-1206
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: