Individual
JAY A JACOBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8TH AVE & C STREET, LDS HOSPITAL, SALT LAKE CITY, UT 84143-1005
(801) 408-1006
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 408-1006
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
1622731205
UT
Other
Enumeration date
07/15/2006
Last updated
10/16/2007
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