MEDICARE: NATHANIEL W DOTSON

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	183500000X	Pharmacist	7450898-1701	UT

General Provider Information

NPI Number	:	1609739010
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATHANIEL W DOTSON

Provider Business Mailing Address
First Line	:	1251 W WIMBLEDON RIDGE LN
Second Line	:
City	:	WEST JORDAN
State	:	UT
Zip	:	84084-3503
Country	:	US
Telephone Number	:	435-691-0818
Fax Number	:

Provider Business Practice Location Address
First Line	:	1459 E 3900 S
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84124-1412
Country	:	US
Telephone Number	:	801-341-1300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/03/2025
Last Update Date	:	12/03/2025

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