Provider Demographics
NPI:1699539791
Name:GATZEMEIER, JEFFREY KURT (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:KURT
Last Name:GATZEMEIER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10716 S MAUGHAN CIR
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-3347
Mailing Address - Country:US
Mailing Address - Phone:801-574-6768
Mailing Address - Fax:801-252-1002
Practice Address - Street 1:4133 W PIONEER PKWY STE 130
Practice Address - Street 2:
Practice Address - City:WEST VALLEY CITY
Practice Address - State:UT
Practice Address - Zip Code:84120-2059
Practice Address - Country:US
Practice Address - Phone:801-252-1000
Practice Address - Fax:888-546-0632
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-08
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT5253103-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist