NPI 1124121934

Jeffrey M Wallentine, MD

Practitioner Orthopaedic Surgery Physician Provo, UT

Practice location

Address: 1055 N 500 W Suite 121, Provo, UT 84604-3305
Phone: (801) 373-7350
Fax: (801) 812-5401
Mailing address: 1055 N 500 W Credentialing Department, Provo, UT 84604-3305

Registered specialties

Orthopaedic Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207X00000X Licence 356423-1205 (UT)

Other Orthopaedic Surgery providers in Utah →

Registry record

NPI: 1124121934
Entity type: Individual
Sex (as registered): Male
NPI issued: 7 Sep 2006
Record last updated: 27 Nov 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.