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NPI Code Detail

MEDICARE: ROBERT JACKSON GARR D.O.

MEDICARE: ROBERT JACKSON GARR D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease Physician4761224-1204UT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1225023088
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT JACKSON GARR D.O.
Provider Business Mailing Address
First Line : PO BOX 30180
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84130-0180
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1300 N 500 E STE 320
Second Line :
City : LOGAN
State : UT
Zip : 84341-2462
Country : US
Telephone Number : 435-716-2200
Fax Number : 435-716-2220
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2005
Last Update Date : 02/03/2026

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Directions to “ ROBERT JACKSON GARR D.O.” Practice Location

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