Individual
JACQUELYN M. SIMONIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
30 N 1900 E RM 4C104, SALT LAKE CITY, UT 84132-0002
(801) 585-1686
Mailing address
30 N 1900 E RM 4C104, SALT LAKE CITY, UT 84132-0002
(801) 585-1686
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
11849354-1205
UT
207P00000X
Emergency Medicine Physician
209357
NC
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
11849354-1205
UT
Other
Enumeration date
04/24/2015
Last updated
12/20/2021
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