Healthcare Provider Details

I. General information

NPI: 1073392643
Provider Name (Legal Business Name): WALTER BARRETT JONES PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2023
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

863 W 450 S STE 101
SPRINGVILLE UT
84663-2299
US

IV. Provider business mailing address

863 W 450 S STE 101
SPRINGVILLE UT
84663-2299
US

V. Phone/Fax

Practice location:
  • Phone: 801-839-5080
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number1-100797
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code1835C0207X
TaxonomyCompounded Sterile Preparations Pharmacist
License Number14253601-1701
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: