Jackson, Kenneth Conrad

Jackson, Kenneth Conrad is an individual health care provider with primary practice located at 546 Chipeta Way Suite 220, Salt Lake City UT 84108-1236. He recently has only one registered license in Pharmacy Service Providers / Pharmacotherapy, which is considered as his primary health care specialty. Jackson, Kenneth Conrad can be contacted via phone (801) 581-7246.

Contact Information

Primary practice address
546 Chipeta Way Suite 220 Salt Lake City UT 84108-1236
Fax: (801) 581-6243
Website:

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacotherapy 1835P1200X 363584-1701 Utah

Profile Details

NPI number 1275514994
LBN Legal business name Jackson, Kenneth Conrad
Credentials PHARM.D., R.PH.
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 9th, 2005
Last updated Aug 1st, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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