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Jeffrey M Wallentine, MD

Orthopaedic Surgery in Provo, UT. Individual provider (NPI-1).

NPI number1124121934
StatusActive
Last updated in NPPESNov 27, 2023

Details

NPI
1124121934
Entity type
Individual (NPI-1)
Name
Jeffrey M Wallentine
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Sep 7, 2006
Certification date
Feb 13, 2020
Last updated
Nov 27, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207X00000X Orthopaedic Surgery356423-1205UTYes

Practice location

1055 N 500 W
Suite 121
Provo, UT 84604-3305

Phone 801-373-7350 · Fax 801-812-5401

Mailing address

1055 N 500 W
Credentialing Department
Provo, UT 84604-3305

Phone 801-354-8225 · Fax 801-418-0941

Other practice locations

700 W 800 N Ste 100
Orem, UT 84057-6301

Phone 801-373-7350

65 E 100 N
Ste A
Gunnison, UT 84634

Phone 801-373-7350

1100 S Medical Dr
Mt Pleasant, UT 84647-2222

Phone 801-373-7350

555 W Sr 164
Salem, UT 84653

Phone 801-373-7350

1130 Smith Fieldhouse
Provo, UT 84602-2246

Phone 801-373-7350

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