Richard T Jackson MD

NPI 1144323163 - Orthopaedic Surgery - 207X00000X

NPI Details
NPI 1144323163
Gender Male
Enumeration Date 09/06/2006
Last Updated 04/11/2008
Entity Type Individual
Active Over 11 years ago
Practice Location
1055 N 500 W
PROVO UT, 84604-3305, US
Phone (801) 373-7350
Fax (801) 812-5401
Business Location
1055 N 500 W
PROVO UT, 84604-3305, US
Phone (801) 354-8225
Fax (801) 429-8150
Taxonomy Code 207X00000X
License State Utah
License Number 158498-1205
Remove 1144323163 NPI Number

According to our database, Richard T Jackson MD NPI is 1144323163, taxonomy code is 207X00000X and license number is 158498-1205, license state is located at Utah. Richard T Jackson MD physically located at 1055 N 500 W, Provo UT, 84604-3305. NPI Number Richard T Jackson MD has the Individual type.

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1144323163 NPI number is provided on an as is basis without warranty of any kind. 1144323163 is maintained by the National Plan & Provider Enumeration System. The contents of Richard T Jackson MD are for informational purposes only.