Individual
DR. SCOTT R. JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
920 N 500 W, PROVO, UT 84604-3339
(801) 374-1801
(801) 375-0369
Mailing address
920 N 500 W, PROVO, UT 84604-3339
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
5853270-1205
UT
Other
Enumeration date
03/21/2007
Last updated
07/08/2007
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