Individual
JEFFREY JACOB SCHENK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1303 N MAIN ST, CEDAR CITY, UT 84721-9746
(435) 868-5567
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0053687
CO
207R00000X
Internal Medicine Physician
DO1992
NV
208M00000X
Hospitalist Physician
Primary
13018467-1204
UT
208M00000X
Hospitalist Physician
DR.0053687
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07307039
—
CO
01
—
P01381223
RAILROAD MEDICARE
CO
Enumeration date
03/11/2011
Last updated
03/22/2023
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