Provider Demographics
NPI:1437437589
Name:CLAWSON, JEFF JOHNSON (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFF
Middle Name:JOHNSON
Last Name:CLAWSON
Suffix:
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 1:139 E SOUTH TEMPLE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84111-1103
Mailing Address - Country:US
Mailing Address - Phone:801-746-5693
Mailing Address - Fax:801-746-3042
Practice Address - Street 1:139 E SOUTH TEMPLE
Practice Address - Street 2:SUITE 500
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84111-1103
Practice Address - Country:US
Practice Address - Phone:801-746-5693
Practice Address - Fax:801-746-3042
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-22
Last Update Date:2011-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT158010-1205207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services