Individual
DR. RYAN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1380 E MEDICAL CENTER DR, ST GEORGE, UT 84790-2123
(435) 634-4000
(678) 285-6777
Mailing address
PO BOX 3570, SALT LAKE CITY, UT 84110-3570
(801) 432-2600
(678) 285-6777
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
9344119-1205
UT
390200000X
Student in an Organized Health Care Education/Training Program
4301087396
MI
Other
Enumeration date
03/30/2007
Last updated
08/18/2016
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