Individual
HEATHER A JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2295 FOOTHILL DR, SALT LAKE CITY, UT 84109-4000
(801) 486-3021
(801) 485-6339
Mailing address
2295 FOOTHILL DR, SALT LAKE CITY, UT 84109-4000
(801) 486-3021
(801) 485-6339
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
7127197-1205
UT
Other
Enumeration date
04/25/2007
Last updated
04/25/2012
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