Individual
JESSICA COMSTOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 N MARIO CAPPECHI DR, PRIMARY CHILDRENS MEDICAL CENTER DEPT OF PATHOLOGY, SALT LAKE CITY, UT 84113
(801) 662-2164
(801) 662-2165
Mailing address
127 S 500 E, 600, SALT LAKE CITY, UT 84102-1959
(801) 587-6336
(801) 715-8228
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
60255741205
UT
207ZP0213X
Pediatric Pathology Physician
6025574-1205
UT
208000000X
Pediatrics Physician
Primary
6025574-1205
UT
Other
Enumeration date
06/24/2008
Last updated
12/03/2021
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