1043325715 NPI number — MR. STEPHEN JASON TOMLINSON PT

Table of content: MR. STEPHEN JASON TOMLINSON PT (NPI 1043325715)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043325715 NPI number — MR. STEPHEN JASON TOMLINSON PT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TOMLINSON
Provider First Name:
STEPHEN
Provider Middle Name:
JASON
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
PT
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043325715
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/27/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1055 N 500 W
Provider Second Line Business Mailing Address:
ATTN: CREDENTIALING
Provider Business Mailing Address City Name:
PROVO
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84604-3305
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
801-354-8225
Provider Business Mailing Address Fax Number:
801-418-0941

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1449 N 1400 W STE 21
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ST GEORGE
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84770-5237
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
435-986-4133
Provider Business Practice Location Address Fax Number:
435-986-4133
Provider Enumeration Date:
08/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  290768-2401 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 875082 . This is a "DMBA" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: 233991 . This is a "ALTIUS" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: 9374195 . This is a "PHCS" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: 02907682405001 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: 060551781 . This is a "TRI CARE" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: 030551781JT2 . This is a "EDUCATORS MUTUAL" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: 107031324102 . This is a "SELECT HEALTH" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: 81821 . This is a "PEHP" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: 610748900 . This is a "OWCP" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: DD2759 . This is a "RR MEDICARE" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".




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