Provider Demographics
NPI:1053117408
Name:STRATTON, ETHAN S
Entity type:Individual
Prefix:
First Name:ETHAN
Middle Name:S
Last Name:STRATTON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2480 RED CLIFFS DR
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-5457
Mailing Address - Country:US
Mailing Address - Phone:435-676-6466
Mailing Address - Fax:
Practice Address - Street 1:2480 RED CLIFFS DR
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-5457
Practice Address - Country:US
Practice Address - Phone:435-673-6446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program