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Benjamin Clark Jacobs, MD
Diagnostic Radiology Physician in Provo, Utah
NPI 1982846119

Benjamin Clark Jacobs is a Diagnostic Radiology Physician based in Provo, UT and is specialized in Diagnostic Radiology. Benjamin Clark Jacobs practices in Provo, UT and has the professional credentials of MD. The NPI Number for Benjamin Clark Jacobs is 1982846119 and holds a License No. (Utah).

The current practice location address for Benjamin Clark Jacobs is 1055 N 500 W, Provo, UT and can be reached out via phone at 801-812-4624 and via fax at 801-812-4699.

Location: 1055 N 500 W, Provo, UT, 84604-3305
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1982846119
Provider Name
Benjamin Clark Jacobs
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
1055 N 500 W, Provo, UT, 84604-3305
Phone Number
801-812-4624
Fax Number
801-812-4699
Provider Enumeration Date
04/02/2009
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1055 N 500 W
City
Provo
State
Utah
Zip
84604-3305
Phone Number
801-812-4624
Fax Number
801-812-4699
person
Provider Business Mailing Address Details
Address
1055 N 500 W
City
Provo
State
Utah
Zip
84604-3305
Phone Number
801-812-4624
Fax Number
801-812-4699
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Diagnostic Radiology
Taxonomy
2085R0202X
License No.
9693882-1205 (Utah)
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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