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Individual

MR. DAVID B JACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
74 E KIMBALLS LN STE 260, DRAPER, UT 84020-5009
(801) 545-8480
(801) 253-1602
Mailing address
PO BOX 198560, ATLANTA, GA 30384-1721

Taxonomy

Speciality
Code
Description
License number
State
207QB0002X
Obesity Medicine (Family Medicine) Physician
Primary
168941-1205
UT

Other

Enumeration date
09/06/2006
Last updated
02/01/2022
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