NPI 1962513820 · live from the CMS NPI Registry
Jason Ross Bowen, DPM
Podiatrist, Foot & Ankle Surgery in Salt Lake City, UT. National Provider Identifier 1962513820, active.
NPI record
| NPI | 1962513820 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Podiatrist, Foot & Ankle Surgery 213ES0103X |
| Practice location | 3710 Twinbrook St, Salt Lake City, UT 84109 |
| Practice phone | 801-278-6603 |
| Enumerated | August 31, 2006 |
| Last updated | November 23, 2021 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist, Foot & Ankle Surgery | 213ES0103X | 0616 (AZ) |
| Podiatrist, Foot & Ankle Surgery | 213ES0103X | E4715 (CA) |
| Podiatrist, Foot & Ankle Surgery primary | 213ES0103X | 0601 (NV) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.