Individual
WILLIAM DANIEL JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 MARIO CAPECCHI DR, SUITE 2650, SALT LAKE CITY, UT 84113-1103
(801) 581-2121
Mailing address
PO BOX 581100, SALT LAKE CITY, UT 84158-1100
(801) 213-3800
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
180909-1205
UT
Other
Enumeration date
11/03/2006
Last updated
10/21/2021
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