Provider Demographics
NPI:1518307230
Name:BADERTSCHER, JAN ENGLE (DO)
Entity Type:Individual
Prefix:DR
First Name:JAN
Middle Name:ENGLE
Last Name:BADERTSCHER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1120 E 100 N
Mailing Address - Street 2:STE. 1
Mailing Address - City:PAYSON
Mailing Address - State:UT
Mailing Address - Zip Code:84651-1633
Mailing Address - Country:US
Mailing Address - Phone:801-754-4848
Mailing Address - Fax:801-754-4844
Practice Address - Street 1:1120 E 100 N
Practice Address - Street 2:STE. 1
Practice Address - City:PAYSON
Practice Address - State:UT
Practice Address - Zip Code:84651-1633
Practice Address - Country:US
Practice Address - Phone:801-754-4848
Practice Address - Fax:801-754-4844
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-26
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT9105696-1204207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine