IndividualActive
Taylor Jackson, DO
NPI 1639757016 · Anatomic Pathology & Clinical Pathology Physician · Salt Lake City, UT
Provider details
- NPI number
- 1639757016
- Entity type
- Individual
- Primary specialty
- Anatomic Pathology & Clinical Pathology PhysicianAllopathic & Osteopathic Physicians
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- License
- 12985852-1204 (UT)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Student, Health Care
Profile Score
Established profile(62/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
15 N Medical Dr Ste 1100
Salt Lake City, UT 84112-1100
Phone: (801) 583-2787
Street-level locationGet directions
Mailing address
15 N Medical Dr Ste 1100
Salt Lake City, UT 84112-1100
Registry dates
- Enumerated
- 2021-03-29
- Last updated
- 2022-08-16
- Certified
- 2022-08-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.