Basic Information
| Provider Information | |||||||||
| NPI: | 1285760132 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NORTH | ||||||||
| FirstName: | JASON | ||||||||
| MiddleName: | KARL | ||||||||
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| Credential: | D.O, | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 27128 | ||||||||
| Address2: | |||||||||
| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841270128 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4352512992 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1380 E MEDICAL CENTER DR | ||||||||
| Address2: | |||||||||
| City: | ST GEORGE | ||||||||
| State: | UT | ||||||||
| PostalCode: | 847902123 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4352512992 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/26/2007 | ||||||||
| LastUpdateDate: | 04/15/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 4909906-1204 | UT | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.