MR. DAVID B JACK (NPI# 1255434296) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255434296 |
| Entity Type | Individual |
| Full Name | MR. DAVID B JACK |
| Credential | MD |
| Practice Address |
11760 S 700 E Ste 111 Draper UT 84020-6605 |
| Mailing Address |
117060 S 700 E #111 Draper UT 84020 |
| Practice Telephone | 8015722504 |
| Practice Fax Number | 8015769800 |
| Mailing Telephone | 8015768855 |
| Mailing Fax Number | 8015769800 |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2014-02-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QB0002X |
Family Medicine Specialization: Obesity Medicine |
168941-1205 | UT | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942664974 | David Jack | Pharmacist | 130 Enterprise Dr, Walgreens Specialty Pharmacy, Pittsburgh, PA 15275-1213 | 2016-04-06 |
| 1235416686 | David Jack | Specialist/Technologist | 1620 E Bulldog Ln, Fresno, CA 93740-0001 | 2011-11-14 |
| Street Address |
11760 S 700 E STE 111 |
| City | DRAPER |
| State | UT |
| Zip Code | 84020-6605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952538605 | Preston Jon Wilson | Family Medicine | 11760 S 700 E Ste 111, Draper, UT 84020-6605 | 2009-06-19 |
| 1760528137 | David B Jack Md PC | Family Medicine | 11760 S 700 E Ste 111, Draper, UT 84020-6605 | 2007-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194322776 | Chase Larsen Dmd Pllc | Dentist | 723 E 12200 S, Draper, UT 84020 | 2020-10-06 |
| 1780222380 | Derek Cragun | Counselor | 11706 700 E, Draper, UT 84020 | 2019-12-13 |
| 1720629371 | Own My Health Medical | Clinic/Center | 12371 900 E, Suite 102, Draper, UT 84020 | 2019-10-04 |
| 1508418856 | Thomas Mifflin | Physician Assistant | 721 East 12200 South, Draper, UT 84020 | 2019-07-16 |
| 1124670872 | Necia Dalley | Registered Nurse | 11800 S State St, Draper, UT 84020 | 2019-07-12 |
| 1285100784 | Tracey M Williams | Psychologist | 13200 S 1601 E, Draper, UT 84020 | 2018-10-23 |
| 1275008328 | Amoni Paeahelotu Finau | Community Health Worker | 13703 Wheatfield Way, Draper, UT 84020 | 2018-10-04 |
| 1891275525 | Cynthia Mae Bolton | Psychologist | 1192 E Draper Parkway # 447, Draper, UT 84020 | 2018-08-21 |
| 1164908026 | Headin' Home Inc. | Community/Behavioral Health | 12300 S. 150 W., Draper, UT 84020 | 2018-07-13 |
| 1366932576 | Forest Hulet | Dentist | 219 E 12300, Ste I-5, Draper, UT 84020 | 2018-05-14 |
| Find all providers in zip 84020 | ||||
| Taxonomy Code | 207QB0002X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Obesity Medicine |
| A physician who specializes in the treatment of obesity demonstrates competency in and a thorough understanding of the treatment of obesity and the genetic, biologic, environmental, social, and behavioral factors that contribute to obesity. The obesity medicine physician employs therapeutic interventions including diet, physical activity, behavioral change, and pharmacotherapy. The obesity medicine physician utilizes a comprehensive approach, and may include additional resources such as dietitians, exercise physiologists, mental health professionals and bariatric surgeons as indicated to achieve optimal results. Additionally, the obesity medicine physician maintains competency in providing pre- peri- and post-surgical care of bariatric surgery patients, promotes the prevention of obesity, and advocates for those who suffer from obesity. |
| Notes: Source: American Board of Obesity Medicine, www.abom.org [7/1/2015: title and definition modified] Additional Resource: American Society of Bariatric Physicians, www.asbp.org. |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.