Individual
JACOB BRANDENBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
SCHOOL OF MEDICINE 30 NORTH 1900 EAST ROOM 3C444, SALT LAKE CITY, UT 84132
(801) 581-6393
Mailing address
SCHOOL OF MEDICINE 30 NORTH 1900 EAST ROOM 3C444, SALT LAKE CITY, UT 84132-0001
(801) 581-6393
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
10970498-1205
UT
Other
Enumeration date
04/10/2017
Last updated
10/28/2021
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