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General NPI Number Information
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NPI Number | 1861501694
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Entity Type | Individual
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Provider Name | JASON M STINNETT MD
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Gender | Male
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 10/10/2016
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Provider Practice Location Address
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Address Line | 1492 W ANTELOPE DR SUITE 125
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City | LAYTON
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State | UT
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Zip | 84041-1139
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Country | US
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Telephone | 801-525-3022
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Fax | 801-775-9508
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Provider Business Mailing Address
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Address Line | 1121 E 3900 S SUITE C-240
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City | SALT LAKE CITY
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State | UT
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Zip | 84124-1214
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Country | US
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Telephone | 801-262-9494
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Fax | 801-266-2074
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | M9050
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | 379443-1205
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License Number State | UT
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