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General NPI Number Information
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NPI Number | 1235496357
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Entity Type | Individual
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Provider Name | JACK DUNYON STRINGHAM II M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/13/2012
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Last Update Date | 08/16/2023
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Provider Practice Location Address
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Address Line | 1055 N 300 W STE 500
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City | PROVO
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State | UT
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Zip | 84604-3312
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Country | US
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Telephone | 801-357-7704
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Fax |
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Provider Business Mailing Address
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Address Line | 1055 N 300 W STE 500
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City | PROVO
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State | UT
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Zip | 84604-3312
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Country | US
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Telephone | 801-357-7704
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | ME127417
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 10775122-1205
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License Number State | UT
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207WX0107X
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Taxonomy Name | Retina Specialist (Ophthalmology) Physician
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License Number | 107751221205
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License Number State | UT
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