Provider Demographics
NPI:1932430782
Name:JEPSON, RUSSELL D (DC)
Entity Type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:D
Last Name:JEPSON
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:PO BOX 912042
Mailing Address - Street 2:
Mailing Address - City:SAINT GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84791-2042
Mailing Address - Country:US
Mailing Address - Phone:435-215-0228
Mailing Address - Fax:435-656-2828
Practice Address - Street 1:2891 E MALL DRIVE
Practice Address - Street 2:STE. 200
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790
Practice Address - Country:US
Practice Address - Phone:435-688-1665
Practice Address - Fax:435-619-8634
Is Sole Proprietor?:No
Enumeration Date:2010-01-19
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11341111NR0400X, 111NS0005X, 111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
No111NR0400XChiropractic ProvidersChiropractorRehabilitation