Individual
DR. DANIEL LARSEN JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
5801 S FASHION BLVD STE 195, MURRAY, UT 84107-8114
(801) 829-7246
(801) 655-9615
Mailing address
5801 S FASHION BLVD STE 195, MURRAY, UT 84107-8114
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
12931506-1204
UT
207LP2900X
Pain Medicine (Anesthesiology) Physician
12931506-1204
UT
208VP0014X
Interventional Pain Medicine Physician
12931506-1204
UT
Other
Enumeration date
04/02/2013
Last updated
08/16/2024
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