Jackson, Richard T

Jackson, Richard T is an individual health care provider with primary practice located at 1055 N 500 W Suite 121, Provo UT 84604-3305. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Jackson, Richard T can be contacted via phone (801) 373-7350.

Contact Information

Primary practice address
1055 N 500 W Suite 121 Provo UT 84604-3305
Phone: (801) 373-7350
Fax: (801) 812-5401
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 158498-1205 Utah

Profile Details

NPI number 1144323163
LBN Legal business name Jackson, Richard T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 6th, 2006
Last updated Nov 27th, 2023 - about last year

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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1144323163 NPPES
Utah Other 36165 DMBA
Utah MEDICAID 870281028000 DMBA
Utah Other 870281028RCH DMBA
Utah Other QM000056630 DMBA
Utah Other 107004917104 DMBA
Utah Other 09-00376 DMBA
Utah Other 20045125 DMBA
Utah Other 68073 DMBA

Popular Providers