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General NPI Number Information
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NPI Number | 1578053138
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Entity Type | Individual
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Provider Name | JAYSON TRIPP DO
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Gender | Male
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Dates
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Enumeration Date | 05/18/2018
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Last Update Date | 06/22/2023
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Provider Practice Location Address
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Address Line | 203 FORT WADE RD UNIT 260
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City | PONTE VEDRA
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State | FL
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Zip | 32081-5159
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Country | US
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Telephone | 801-821-2333
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Fax | 801-901-1194
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Provider Business Mailing Address
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Address Line | 3300 N TRIUMPH BLVD STE 500
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City | LEHI
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State | UT
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Zip | 84043-6475
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Country | US
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Telephone | 844-692-4100
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Fax | 801-901-1194
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | S015504
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 12306263-1204
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License Number State | UT
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | DR.0066525
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 009117
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License Number State | AZ
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Taxonomy #5
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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 #6
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 2020-03587
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License Number State | NC
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