NPI 1134198419

Jared a Green, PAC

Practitioner Physician Assistant Cedar City, UT

Practice location

Address: 1870 N Main St STE 201, Cedar City, UT 84721-7742
Phone: (435) 383-9009
Fax: (435) 383-9010
Mailing address: 1055 North 500 West Attn: Credentialing, Provo, UT 84604-3305

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 8441754-1206 (UT)

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Registry record

NPI: 1134198419
Entity type: Individual
Sex (as registered): Male
NPI issued: 17 Mar 2006
Record last updated: 25 Mar 2025

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.