Individual
GREG ROBERT JACOBSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
383 S 300 E, ST GEORGE, UT 84770-3620
(435) 628-2826
Mailing address
383 S 300 E, ST GEORGE, UT 84770-3620
(435) 628-2826
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
7153621-1205
UT
207N00000X
Dermatology Physician
MT187813
PA
Other
Enumeration date
05/21/2007
Last updated
06/19/2009
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