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General NPI Number Information
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NPI Number | 1750025532
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Entity Type | Individual
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Provider Name | JACOB S. KLUVER MD
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Gender | Male
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Dates
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Enumeration Date | 04/26/2022
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 295 S CHIPETA WAY RM 2000
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City | SALT LAKE CITY
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State | UT
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Zip | 84108-1287
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Country | US
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Telephone | 801-581-2121
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Fax | 919-966-8419
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Provider Business Mailing Address
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Address Line | 295 S CHIPETA WAY RM 2000
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City | SALT LAKE CITY
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State | UT
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Zip | 84108-1287
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Country | US
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Telephone | 801-581-2121
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Fax | 919-966-8419
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0207X
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Taxonomy Name | Pediatric Hematology & Oncology Physician
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License Number | 14206539-1205
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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