IndividualActive
Mark Jackson, MD
NPI 1003877077 · Emergency Medical Services (Emergency Medicine) Physician · Tooele, UT
Provider details
- NPI number
- 1003877077
- Entity type
- Individual
- Primary specialty
- Emergency Medical Services (Emergency Medicine) PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 5929640-1205 (UT)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
1474 E Erda Way
Tooele, UT 84074-9737
Phone: (435) 849-0779
Approximate (ZIP-level) locationGet directions
Mailing address
1474 E Erda Way
Tooele, UT 84074-9737
Registry dates
- Enumerated
- 2006-03-30
- Last updated
- 2016-03-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.