Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Nathan Jacob Gottfredson, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1558162867

Nathan Jacob Gottfredson, MD is a Student in an Organized Health Care Education/Training Program in Provo, Utah. Practices as a sole proprietor. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

475 W 940 N
Provo, UT 84604-3301
Phone: (801) 357-7930
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1558162867
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedMarch 22, 2025
Last updated in NPPESMarch 22, 2025
Certification dateMarch 22, 2025

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