Jacob Stout

NPI #1952037939 in South Salt Lake, Utah

Provider Information

NPI Number: 1952037939
Entity Type: Individual
Name: Jacob Stout
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Enumeration Date: Aug 1, 2022
Last Updated: Nov 1, 2023

Practice Location

Address: 2472 S 300 E
City: South Salt Lake
State: Utah
ZIP Code: 84115-2895
Phone: (801) 783-5011

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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