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Individual

MICHAEL S JENNINGS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4525 WASATCH BLVD, STE 310, SALT LAKE CITY, UT 84124-4700
(801) 998-8492
(801) 998-8489
Mailing address
4525 WASATCH BLVD, STE 310, SALT LAKE CITY, UT 84124-4700
(801) 998-8492
(801) 998-8489

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2637851205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
870573947004
UT
Enumeration date
02/22/2006
Last updated
12/27/2009
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