BENJAMIN CLARK JACOBS

PROVO, UT
NPI1982846119
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2085R0202X Radiology, Diagnostic Radiology
(Licence: UT  9693882-1205)
Enumeration Date2009-04-02
Last Update Date2025-03-25
Business Address
BENJAMIN CLARK JACOBS MD
1055 N 500 W STE 112
PROVO, UT 84604-3305
Phone number: 801-812-4624
Mailing Address
BENJAMIN CLARK JACOBS MD
1055 N 500 W ATTN: CREDENTIALING
PROVO, UT 84604-3305
Phone number: 801-354-8225
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