Provider Demographics
NPI:1730709015
Name:HWP MED, L.L.C.
Entity type:Organization
Organization Name:HWP MED, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:VANSHAAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-341-8729
Mailing Address - Street 1:1831 E 6550 S
Mailing Address - Street 2:
Mailing Address - City:UINTAH
Mailing Address - State:UT
Mailing Address - Zip Code:84405-9729
Mailing Address - Country:US
Mailing Address - Phone:385-240-1963
Mailing Address - Fax:888-747-8076
Practice Address - Street 1:1831 E 6550 S
Practice Address - Street 2:
Practice Address - City:UINTAH
Practice Address - State:UT
Practice Address - Zip Code:84405-9729
Practice Address - Country:US
Practice Address - Phone:385-240-1963
Practice Address - Fax:888-747-8076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-16
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty