Provider Demographics
NPI:1801872569
Name:NEUMAN, JODY S (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JODY
Middle Name:S
Last Name:NEUMAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 FOOTHILL DR
Mailing Address - Street 2:MADSEN HEALTH CLINIC
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84112-1106
Mailing Address - Country:US
Mailing Address - Phone:801-339-5738
Mailing Address - Fax:801-581-8937
Practice Address - Street 1:4543 ZARAHEMLA DR
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84124-4039
Practice Address - Country:US
Practice Address - Phone:801-274-9595
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT148392-17011835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy