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General NPI Number Information
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NPI Number | 1093949620
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Entity Type | Individual
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Provider Name | JOHN JOSEPH MANGELSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/11/2009
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 98 N 1100 E STE 103
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City | AMERICAN FORK
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State | UT
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Zip | 84003-2940
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Country | US
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Telephone | 801-492-2330
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 27128
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City | SALT LAKE CITY
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State | UT
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Zip | 84127-0128
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Country | US
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Telephone |
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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 | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number | 8978841-1205
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | DR.0055843
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License Number State | CO
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