Provider Demographics
NPI:1639531650
Name:JEX, BRADEN WOODHOUSE (DO)
Entity Type:Individual
Prefix:
First Name:BRADEN
Middle Name:WOODHOUSE
Last Name:JEX
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 912042
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84791-2042
Mailing Address - Country:US
Mailing Address - Phone:435-215-0230
Mailing Address - Fax:435-986-7092
Practice Address - Street 1:8828 MOHAWK ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89139-7011
Practice Address - Country:US
Practice Address - Phone:702-880-4193
Practice Address - Fax:702-586-6728
Is Sole Proprietor?:No
Enumeration Date:2016-03-28
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13703732-1204207LP2900X
WI67890-21207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine