Provider Demographics
NPI:1538250287
Name:FAUX, JONATHAN R (MD)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:R
Last Name:FAUX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 N 500 W
Mailing Address - Street 2:CREDENTIALING DEPARTMENT
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-3305
Mailing Address - Country:US
Mailing Address - Phone:801-354-8225
Mailing Address - Fax:801-418-0941
Practice Address - Street 1:1055 N 500 W
Practice Address - Street 2:SUITE 121
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-3305
Practice Address - Country:US
Practice Address - Phone:801-373-7350
Practice Address - Fax:801-812-5401
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5269192-1205207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTP000048647OtherPALMETTO
UT09-00489OtherUTAH HEALTCARE
UT794776OtherDMBA
UT107018895101OtherIHC
UT870287028FA2OtherEMIA
UTQM0000067760OtherALTIUS
UT72720OtherPEHP
UTQM0000067760OtherALTIUS
UTP000048647OtherPALMETTO
UT870287028FA2OtherEMIA
UT09-00489OtherUTAH HEALTCARE
UT005502542Medicare PIN