# JACKSON R FITZGERALD

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1730283268
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | 185769-1205 | UT | Yes |

## Other

- **Enumeration date:** 09/13/2006
- **Last updated:** 07/08/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 107007001102 | IHC | UT |
| 01 | — | 212704 | DESERET MUTUAL | UT |
| 01 | — | 32664 | PEHP | UT |
| 01 | — | 52944 | HEALTHY U | UT |
| 01 | — | 870525882FI1 | EDUCATORS MUTUAL | UT |
| 01 | — | PR00525 | MOLINA | UT |
| 01 | — | QM0000076595 | ALTIUS | UT |