Individual
JACK MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
30 N. MARIO CAPECCHI,, HELIX BUILDING, LEVEL 2 SOUTH, SALT LAKE CITY, UT 84112
(801) 581-2417
Mailing address
30 N. MARIO CAPECCHI, SALT LAKE CITY, UT 84112
(801) 581-2417
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
14242627-1205
UT
Other
Enumeration date
05/17/2024
Last updated
11/19/2025
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