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Individual

DR. AUDREY A JIRICKO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
4403 HARRISON BLVD, STE #4815, OGDEN, UT 84403-3271
(801) 387-8350
(801) 387-8355
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 779-6200

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
5672616-1205
UT
207V00000X
Obstetrics & Gynecology Physician
56726168905
UT

Other

Enumeration date
08/28/2006
Last updated
02/19/2009
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