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General NPI Number Information
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NPI Number | 1063444677
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Entity Type | Organization
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Legal Business Name | NORTH FAMILY PRACTICE, P.C.
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 08/17/2007
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Provider Practice Location Address
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Address Line | 55 E CANYON COMMERCIAL AVE
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City | CEDAR CITY
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State | UT
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Zip | 84720-7784
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Country | US
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Telephone | 435-867-8050
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Fax | 435-867-8083
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Provider Business Mailing Address
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Address Line | 55 E CANYON COMMERCIAL AVE
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City | CEDAR CITY
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State | UT
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Zip | 84720-7784
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Country | US
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Telephone | 435-867-8050
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Fax | 435-867-8083
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. JASON K NORTH
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Credential | D.O.
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Telephone | 435-867-8050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4909906-1204
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License Number State | UT
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