Jacobs, John M

Jacobs, John M is an individual health care provider with primary practice located at 5444 Green St , Murray UT 84123-5632. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Jacobs, John M can be contacted via phone (801) 262-8120.

Contact Information

Primary practice address
5444 Green St Murray UT 84123-5632
Phone: (801) 262-8120
Fax: (801) 262-5721
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 168972-1205 Utah
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X 168972-1205 Utah
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X M-8403 Idaho

Profile Details

NPI number 1912947995
LBN Legal business name Jacobs, John M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 7th, 2006
Last updated Sep 12th, 2012 - about 12 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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Identifiers

StateTypeNumberIssuer
All States NPI 1912947995 NPPES
Utah MEDICAID 07258

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