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General NPI Number Information
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NPI Number | 1700952231
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Entity Type | Individual
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Provider Name | JOSEPH GREGORY KJAR M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/27/2006
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Last Update Date | 07/24/2015
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Provider Practice Location Address
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Address Line | 415 MEDICAL DR STE #B-200
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City | BOUNTIFUL
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State | UT
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Zip | 84010-4946
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Country | US
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Telephone | 801-295-9105
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Fax | 801-295-9264
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Provider Business Mailing Address
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Address Line | 415 MEDICAL DR STE #B-200
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City | BOUNTIFUL
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State | UT
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Zip | 84010-4946
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Country | US
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Telephone | 801-295-9105
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Fax | 801-295-9264
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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 | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 170345-8905
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License Number State | UT
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