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NPI Code Detail

MEDICARE: DR. JAKE DOYLE VEIGEL M.D.

MEDICARE:  DR. JAKE DOYLE VEIGEL  M.D.
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
1207Q00000XFamily Medicine Physician344837-1205UT
2207QS0010XSports Medicine (Family Medicine) Physician344837UT
3207QS0010XSports Medicine (Family Medicine) Physician344837-1205UT

General Provider Information

NPI Number : 1720196785
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAKE DOYLE VEIGEL M.D.
Provider Business Mailing Address
First Line : 2000 S 900 E
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84105-3208
Country : US
Telephone Number : 801-464-7500
Fax Number : 801-464-7558
Provider Business Practice Location Address
First Line : 5373 W LAKE PARK BLVD
Second Line :
City : WEST VALLEY CITY
State : UT
Zip : 84120-8208
Country : US
Telephone Number : 801-902-7960
Fax Number : 801-902-7999
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2006
Last Update Date : 01/28/2025

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