FRED JESTON DAWSON

PROVO, UT
NPI1316106131
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2085R0202X Radiology, Diagnostic Radiology
(Licence: UT  9282119-1205)
Additional Taxonomies2085R0202X Radiology, Diagnostic Radiology
(Licence: IN  11013885A)
2085R0202X Radiology, Diagnostic Radiology
(Licence: AZ  41926)
Enumeration Date2008-06-06
Last Update Date2023-11-27
Business Address
FRED JESTON DAWSON M.D.
1055 N 500 W SUITE 112
PROVO, UT 84604-3305
Phone number: 801-812-4624
Mailing Address
FRED JESTON DAWSON M.D.
1055 N 500 W ATTN: CREDENTIALING
PROVO, UT 84604-3305
Phone number: 801-354-8225