Individual
DR. JED CRAIG SOUTHWICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4401 HARRISON BLVD, OGDEN, UT 84403-3195
(801) 387-7615
Mailing address
357 E 3700 N, NORTH OGDEN, UT 84414-2749
(801) 782-5310
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
6456430-1205
UT
207P00000X
Emergency Medicine Physician
88435
OH
Other
Enumeration date
05/22/2007
Last updated
11/21/2007
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