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General NPI Number Information
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NPI Number | 1407002553
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Entity Type | Organization
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Legal Business Name | JED R BINDRUP MD PC
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Dates
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Enumeration Date | 08/08/2008
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Last Update Date | 08/08/2008
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Provider Practice Location Address
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Address Line | 11762 S STATE ST STE 260
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City | DRAPER
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State | UT
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Zip | 84020-7156
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Country | US
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Telephone | 801-316-1313
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Fax | 801-316-1314
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Provider Business Mailing Address
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Address Line | 11762 S STATE ST STE 260
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City | DRAPER
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State | UT
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Zip | 84020-7156
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Country | US
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Telephone | 801-316-1313
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Fax | 801-316-1314
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Authorized Official
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Title or Position | OWNER
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Name | JED REED BINDRUP
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Credential | MD
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Telephone | 801-316-1313
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 288635-1205
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License Number State | UT
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