Wackerbarth, Jesse P.
Wackerbarth, Jesse P. is an individual health care provider with primary practice located at 26 N 1900 E Rm 701 , Salt Lake City UT 84132-0002. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Wackerbarth, Jesse P. can be contacted via phone (801) 581-2121.Contact Information
Primary practice address
26 N 1900 E Rm 701
Salt Lake City UT 84132-0002
Phone: (801) 581-2121
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | MD61094335 | Washington |
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | 13312672-1205 | Utah |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 13312672-1205 | Utah |
Profile Details
| NPI number | 1902303613 |
|---|---|
| LBN Legal business name | Wackerbarth, Jesse P. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 9th, 2018 |
| Last updated | Mar 21st, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1902303613 | NPPES |
| Washington | MEDICAID | 1902303613 |
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