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NPI Code Detail

MEDICARE: JENNIFER MYERS COOMBS PA

MEDICARE: JENNIFER MYERS COOMBS PA
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
1363AM0700XMedical Physician Assistant105924-1206UT

General Provider Information

NPI Number : 1518964659
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER MYERS COOMBS PA
Provider Business Mailing Address
First Line : 127 S 500 E
Second Line : STE 600
City : SALT LAKE CITY
State : UT
Zip : 84102-1959
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 50 N MEDICAL DR
Second Line :
City : SLC
State : UT
Zip : 84132-0001
Country : US
Telephone Number : 801-581-7818
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2005
Last Update Date : 03/21/2017

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Directions to “ JENNIFER MYERS COOMBS PA” Practice Location

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