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Contact Information

JOHN C JACOBS JR, MD
5171 S COTTONWOOD ST STE 740
MURRAY, UT84107-5705
 Phone: 801-507-9700
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for JOHN C JACOBS JR · (Male)

NPI # 1336679430
Status Active
Credentials MD
Entity Individual
Enumeration date 06/13/2017
Last updated 08/17/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • IN License # 01080994A
  • IN License # 11019354A
  • UT License # 117034591205
  • IN Medicaid 300017612
Hospital affiliation(s)
  • ALTA VIEW HOSPITAL - (Acute Care)
    9660 SOUTH 1300 EAST
    SANDY, UT 84094
  • INTERMOUNTAIN MEDICAL CENTER - (Acute Care)
    5121 SOUTH COTTONWOOD STREET
    MURRAY, UT 84107
  • LDS HOSPITAL - (Acute Care)
    8TH AVENUE AND C STREET
    SALT LAKE CITY, UT 84143
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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