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

Samuel McClellan Jacobsen

Individual provider Family Medicine Physician · NPI 1720701766

Samuel McClellan Jacobsen is a Family Practice in Layton, Utah. Graduated from Oklahoma State University College of Osteopathic Medicine in 2024, 2 years ago. Licensed in Utah.

Years since qualifying
2
Trained at
Oklahoma State University College of Osteopathic Medicine
Licensed in
UT
In the registry since
2022
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

201 W Layton Pkwy Ste 1A
Layton, UT 84041-3692
Phone: (801) 543-6875
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 14234126-1204 (UT)

Record details

NPI number1720701766
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 23, 2022
Last updated in NPPESNovember 25, 2025
Certification dateNovember 25, 2025
Mailing addressPo Box 27128, Salt Lake City, UT 84127-0128

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOKLAHOMA STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Layton