Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jacob Glen Anderson, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1821733080

Jacob Glen Anderson, MD is a Student in an Organized Health Care Education/Training Program in Salt Lake City, Utah. Works from 2 locations. Licensed in Utah.

Licensed in
UT
In the registry since
2022
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

81 N Mario Capecchi Dr # 4B056
Salt Lake City, UT 84113-1125
Phone: (801) 581-2121
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1919 E Thomas Rd, Phoenix, AZ 85016-7710 — (602) 933-0945

Specialties & licences

Pediatric Rheumatology Physician (primary) Taxonomy 2080P0216X · Licence 14210863-1205 (UT)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X · Licence 390200000X

Record details

NPI number1821733080
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 2, 2022
Last updated in NPPESMarch 19, 2025
Certification dateMarch 19, 2025

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