MEDICARE: JASON B DICKERSON DPM LC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician
2	213ES0103X	Foot & Ankle Surgery Podiatrist	4830364-0501	UT
3	213ES0103X	Foot & Ankle Surgery Podiatrist

General Provider Information

NPI Number	:	1164925467
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JASON B DICKERSON DPM LC

Provider Business Mailing Address
First Line	:	5801 S FASHION BLVD STE 120
Second Line	:
City	:	MURRAY
State	:	UT
Zip	:	84107-8115
Country	:	US
Telephone Number	:	801-261-1391
Fax Number	:	801-261-1394

Provider Business Practice Location Address
First Line	:	5801 S FASHION BLVD STE 120
Second Line	:
City	:	MURRAY
State	:	UT
Zip	:	84107-8115
Country	:	US
Telephone Number	:	801-261-1391
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIALING SPECIALIST
Name	:	WHITNEY LOFTHOUSE
Credential	:
Telephone Number	:	530-925-6027

Provider Enumeration Date	:	03/13/2018
Last Update Date	:	12/18/2024

Similar Medicare Providers

1972786598 — MARK D SCHOLL M D P C
Practice Location Address:

5801 S FASHION BLVD STE 120
MURRAY, UT
84107-8115

Practice Phone: 801-261-1391
Practice Fax: 801-261-1394

1073533188 — SANDRA LOUISE MCNICOLL APRN
Practice Location Address:

5801 FASHION BLVD STE 175
MURRAY, UT
84107-8115

Practice Phone: 801-314-4544
Practice Fax:

1154341279 — CHRISTOPHER JOHN DEHAAN LCSW
Practice Location Address:

5801 FASHION BLVD STE 175
MURRAY, UT
84107-8115

Practice Phone: 801-314-4544
Practice Fax:

1861656332 — CLINT LARSEN DPM
Practice Location Address:

5801 S FASHION BLVD , STE 120
MURRAY, UT
84107-8115

Practice Phone: 801-261-1391
Practice Fax:

1528354693 — DR. THOMAS VANCE EDDY DPM
Practice Location Address:

5801 S FASHION BLVD STE 120
MURRAY, UT
84107-8115

Practice Phone: 801-261-1391
Practice Fax:

1629478862 — JOSHUA KING L.M.T
Practice Location Address:

5801 S FASHION BLVD STE 175
MURRAY, UT
84107-8115

Practice Phone: 801-910-6683
Practice Fax:

Directions to “JASON B DICKERSON DPM LC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.