Jacob Stout
Jacob Stout is a Physician Assistant in South Salt Lake, Utah. Qualified in 2023, 3 years ago. Practices with Santibanez PAC Utah, a 24-clinician group and accepts Medicare assignment. Licensed in Utah.
- Years since qualifying
- 3
- Licensed in
- UT
- In the registry since
- 2022
Practice location Address checks out
2472 S 300 ESouth Salt Lake, UT 84115-2895
Phone: (801) 783-5011
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Physician Assistant (primary) | Taxonomy 363A00000X · Licence 13593511-1206 (UT) |
|---|
Record details
| NPI number | 1952037939 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | August 1, 2022 |
| Last updated in NPPES | November 1, 2023 |
| Certification date | November 1, 2023 |
Medicare enrollment
| Medicare specialty | PHYSICIAN ASSISTANT |
|---|---|
| Medical school | OTHER |
| Graduated | 2023 (3 years in practice) |
| Group practice | Santibanez Pac Utah — 24 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
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Anna I Mair, C-PA
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MS. Reem Heaven Nev Bahar, PA
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