Basic Information
Provider Information
NPI: 1265852917
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CRISAFI
FirstName: JARED
MiddleName: FRANCIS
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 27128
Address2:  
City: SALT LAKE CITY
State: UT
PostalCode: 841270128
CountryCode: US
TelephoneNumber: 4352512500
FaxNumber:  
Practice Location
Address1: 1380 E MEDICAL CENTER DR
Address2:  
City: ST GEORGE
State: UT
PostalCode: 847902123
CountryCode: US
TelephoneNumber: 4352512500
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/21/2014
LastUpdateDate: 07/19/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/19/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X12302986-1205UTN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RC0000X12302986-1205UTN Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
207RI0011X12302986-1205UTY Allopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology

No ID Information.


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