Individual
JEREMY T BOOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4401 HARRISON BLVD, OGDEN, UT 84403-3195
(801) 387-7615
(801) 387-7667
Mailing address
PO BOX 30180, SALT LAKE CITY, UT 84130-0180
(801) 389-8091
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
296143-1205
UT
Other
Enumeration date
08/12/2006
Last updated
01/20/2016
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