Provider Demographics
NPI:1932106788
Name:ATKINSON, JASON D (DC)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:D
Last Name:ATKINSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 E 200 N
Mailing Address - Street 2:
Mailing Address - City:KAYSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84037-1952
Mailing Address - Country:US
Mailing Address - Phone:801-593-8112
Mailing Address - Fax:801-593-0768
Practice Address - Street 1:73 E 200 N
Practice Address - Street 2:
Practice Address - City:KAYSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84037-1952
Practice Address - Country:US
Practice Address - Phone:801-593-8112
Practice Address - Fax:801-593-0768
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT373666-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTU76672Medicare UPIN
UT000012220Medicare ID - Type UnspecifiedMEDICARE #