Healthcare Provider Details

I. General information

NPI: 1518057116
Provider Name (Legal Business Name): KIRTLY PARKER JONES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 07/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 N 1900 E SUITE 2B200
SALT LAKE CITY UT
84132-0002
US

IV. Provider business mailing address

30 N 1900 E SUITE 2B200
SALT LAKE CITY UT
84132-0002
US

V. Phone/Fax

Practice location:
  • Phone: 801-581-3834
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number169897-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: