Individual
ALI BEN-JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1281 NORTH 600 EAST, LOGAN, UT 84341-2443
(435) 752-5999
(435) 752-5551
Mailing address
1281 NORTH 600 EAST, LOGAN, UT 84341-2443
(435) 752-5999
(435) 752-5551
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
292373-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1083611669
NATIONAL PROVIDER IDENTIFIER
UT
Enumeration date
06/28/2005
Last updated
11/03/2014
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