Individual
DR. EILEEN KEENAN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
51 E MAIN ST., MORONI, UT 84646
(435) 436-5250
(435) 436-5262
Mailing address
51 E MAIN ST., MORONI, UT 84646
(435) 283-4076
(435) 283-4078
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3687031205
UT
Other
Enumeration date
06/06/2006
Last updated
03/23/2015
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