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1255421855
BRIAN R JACKSON
SALT LAKE CITY, UT
NPI
1255421855
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine
(Licence: UT 5247478-1205)
Enumeration Date
2006-10-13
Last Update Date
2012-07-06
Business Address
BRIAN R JACKSON MD
500 E CHIPETA WAY
SALT LAKE CITY, UT 84108-1221
Phone number: 801-583-2787
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Mailing Address
BRIAN R JACKSON MD
500 E CHIPETA WAY
SALT LAKE CITY, UT 84108-1221
Phone number: 801-583-2787
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