Individual
ZACHARY R. JERGENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
615 S ARAPEEN DR STE 100, SALT LAKE CITY, UT 84108-1239
(801) 581-6393
Mailing address
615 S ARAPEEN DR STE 100, SALT LAKE CITY, UT 84108-1239
(801) 581-6393
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
12751738-1205
UT
207L00000X
Anesthesiology Physician
2018020285
MO
207L00000X
Anesthesiology Physician
2020029411
MO
207LP2900X
Pain Medicine (Anesthesiology) Physician
12751738-1205
UT
Other
Enumeration date
06/21/2018
Last updated
08/12/2022
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