Dr. Jonathan Shumway, DO
Family Medicine in Salem, UT. Individual provider (NPI-1).
NPI number1982108650
StatusActive
Last updated in NPPESJun 29, 2021
Details
- NPI
- 1982108650
- Entity type
- Individual (NPI-1)
- Name
- Dr. Jonathan Shumway
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 19, 2018
- Certification date
- Jun 29, 2021
- Last updated
- Jun 29, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 12244727-1204 | UT | Yes |
Practice location
555 W Sr 164Salem, UT 84653
Phone 801-465-4896 · Fax 801-465-3267
Mailing address
1055 N 500 WAttn Credentialing
Provo, UT 84604
Phone 801-354-8225 · Fax 801-418-0941
Other practice locations
1500 S Main St
Fort Worth, TX 76104-4941
Fort Worth, TX 76104-4941
Phone 817-702-1173
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