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NPI Profile for Dr EDWARD W JACKSON in SPRINGVILLE, UT.
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Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Adult Medicine |
207QA0505X | 08 | Physician/Family Practice | |
Family Medicine |
207Q00000X | 08 | Physician/Family Practice |
| NPI Number | 1487367728 |
|
| Status | Active | |
| Credentials | MD | |
| Entity | Individual | |
| Enumeration date | 01/02/2023 | |
| Last updated | 01/02/2023 - About 3 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
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|
| Hospital affiliation(s) | Not Available |
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EDWARD W JACKSON
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EDWARD W JACKSON, MD