IndividualActive
Benjamin Jacobs, MD
NPI 1982846119 · Diagnostic Radiology Physician · Provo, UT
Provider details
- NPI number
- 1982846119
- Entity type
- Individual
- Primary specialty
- Diagnostic Radiology PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 9693882-1205 (UT)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
1055 N 500 W
Ste 112
Provo, UT 84604-3305
Phone: (801) 812-4624
Fax: (801) 812-4699
Approximate (ZIP-level) locationGet directions
Mailing address
1055 N 500 W
Provo, UT 84604-3305
Registry dates
- Enumerated
- 2009-04-02
- Last updated
- 2025-03-25
- Certified
- 2025-03-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.