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General NPI Number Information
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NPI Number | 1043214935
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Entity Type | Individual
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Provider Name | JONATHAN PEARSON DANIELS MD
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Gender | Male
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Dates
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Enumeration Date | 06/08/2005
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Last Update Date | 06/02/2022
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Provider Practice Location Address
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Address Line | 82 S 1100 E STE 305
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City | SALT LAKE CITY
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State | UT
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Zip | 84102-4703
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Country | US
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Telephone | 801-214-7650
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Fax | 801-214-7650
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Provider Business Mailing Address
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Address Line | 1422 S ROXBURY RD
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City | SALT LAKE CITY
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State | UT
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Zip | 84108-2843
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Country | US
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Telephone | 801-505-3182
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 17073
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | C50108
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 0429296
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License Number State | KS
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Taxonomy #4
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 73994128017
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License Number State | UT
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Taxonomy #5
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 7399412-1205
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License Number State | UT
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