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
Phone: (801) 583-2787
Fax: (801) 584-5141
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Hematology | 207ZH0000X | 9291 | Nevada |
| Allopathic & Osteopathic Physicians / Hematology | 207ZH0000X | G86484 | California |
| Allopathic & Osteopathic Physicians / Hematology | 207ZH0000X | 3403921205 | Utah |
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | 9291 | Nevada |
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | G86484 | California |
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | 3403921205 | Utah |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1346201209 | NPPES |
| Nevada | MEDICAID | 200225018 |
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