Hussong, Jerry William

Hussong, Jerry William is an individual health care provider with primary practice located at 500 S Chipeta Way , Salt Lake City UT 84108-1221. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hematology, Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology. Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology is his primary health care specialty. Hussong, Jerry William can be contacted via phone (801) 583-2787.

Contact Information

Primary practice address
500 S Chipeta Way Salt Lake City UT 84108-1221
Fax: (801) 584-5141
Website:

Profile Details

NPI number 1346201209
LBN Legal business name Hussong, Jerry William
Credentials DDS MD
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 30th, 2006
Last updated Oct 29th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346201209 NPPES
Nevada MEDICAID 200225018

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