Individual
JORGAN HOGGAN JACOBSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0001
(801) 587-8368
Mailing address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0001
(801) 587-8368
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
10948626-1206
UT
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
08/23/2018
Last updated
10/21/2021
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