Individual provider · Type 1 NPI

Jordan Lee Bagnall, MD

Student in an Organized Health Care Education/Training Program · Salt Lake City, UT

NPI number 1497558985 Active

Practice location

195 Central Campus Dr
Salt Lake City, UT 84112-0519

Call (801) 581-3811 Map

Mailing address

1505 Broad Ave Apt A
Charlottesville, VA 22903-3721

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1497558985

Jordan Lee Bagnall, MD's National Provider Identifier is 1497558985, issued on Mar 31, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Salt Lake City, UT. The record was last updated on Mar 31, 2025.