Provider Demographics
NPI:1215315817
Name:JARAMILLO, TODD JOSEPH (DPM)
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:JOSEPH
Last Name:JARAMILLO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:280 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-6236
Mailing Address - Country:US
Mailing Address - Phone:801-505-0821
Mailing Address - Fax:801-505-0803
Practice Address - Street 1:1355 N UNIVERSITY AVE STE 125
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-2722
Practice Address - Country:US
Practice Address - Phone:801-374-3010
Practice Address - Fax:801-377-2426
Is Sole Proprietor?:No
Enumeration Date:2015-05-14
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10683749-0501213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery