Organization
TX-CARBON EMERGENCY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACOB R POWELL DO (SOLE PROPRIETOR)
(801) 367-6406
Entity
Organization
Contact information
Practice address
300 N HOSPITAL DR, PRICE, UT 84501-4218
(435) 637-4800
Mailing address
2500 W 840 N, PRICE, UT 84501-4605
(801) 367-6406
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
03/26/2019
Last updated
05/01/2019
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