Individual
RACHAEL SUE JACOBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
65 MARIO CAPECCHI DR, SALT LAKE CITY, UT 84132-0001
(801) 581-2352
Mailing address
PO BOX 413075, SALT LAKE CITY, UT 84141-3075
(801) 213-3900
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
5764061-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1265659213
—
WI
01
—
60966
DEAN HEALTH INSURANCE
WI
Enumeration date
04/19/2007
Last updated
10/21/2021
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