Provider Demographics
NPI:1235496357
Name:STRINGHAM, JACK DUNYON II (MD)
Entity Type:Individual
Prefix:DR
First Name:JACK
Middle Name:DUNYON
Last Name:STRINGHAM
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 N 300 W STE 500
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-3312
Mailing Address - Country:US
Mailing Address - Phone:801-357-7704
Mailing Address - Fax:
Practice Address - Street 1:1055 N 300 W STE 500
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-3312
Practice Address - Country:US
Practice Address - Phone:801-357-7704
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-13
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME127417207W00000X
UT10775122-1205207W00000X
390200000X
UT107751221205207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program