Mr Byron J Moulton, AUDIOLOGIST | |
1034 N 500 W, Provo, UT 84604-3380 | |
(801) 373-7850 | |
(801) 357-7997 |
Full Name | Mr Byron J Moulton |
---|---|
Gender | Male |
Speciality | Audiologist |
Location | 1034 N 500 W, Provo, Utah |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1386667293 | NPI | - | NPPES |
57266144101 | Other | UT | UTAH STATE LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
231H00000X | Audiologist | 57266144101 (Utah) | Primary |
Provider Name | Ihc Health Services Inc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1629260880 PECOS PAC ID: 1850209420 Enrollment ID: O20031105000079 |
Provider Name | Ihc Health Services Inc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1942325154 PECOS PAC ID: 1850209420 Enrollment ID: O20080610000303 |
Mailing Address | Practice Location Address |
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Mr Byron J Moulton, AUDIOLOGIST Po Box 30180, Salt Lake City, UT 84130-0180 Ph: (801) 357-7475 | Mr Byron J Moulton, AUDIOLOGIST 1034 N 500 W, Provo, UT 84604-3380 Ph: (801) 373-7850 |
Melissa Davalos Serna, AUD Audiologist Medicare: Not Enrolled in Medicare Practice Location: 1055 N 300 W Ste 211, Provo, UT 84604 Phone: 801-852-9696 | |
Steven Forsey, AUD Audiologist Medicare: Accepting Medicare Assignments Practice Location: 1055 N 300 W, Ste 401, Provo, UT 84604 Phone: 801-357-7499 Fax: 801-373-5980 | |
Bennett Joseph Chargo, Audiologist Medicare: Accepting Medicare Assignments Practice Location: 1832 N 1120 W, Provo, UT 84604 Phone: 801-495-4800 | |
Mindy Ann Norris, AUD Audiologist Medicare: Medicare Enrolled Practice Location: 1034 N 500 W, Provo, UT 84604 Phone: 801-357-7448 | |
Adam Scott Ireland, AUD CCC-A Audiologist Medicare: Accepting Medicare Assignments Practice Location: 2230 N University Pkwy Ste 9b, Provo, UT 84604 Phone: 801-375-3175 Fax: 801-375-2818 | |
Curtis G Thomas, AUD Audiologist Medicare: Accepting Medicare Assignments Practice Location: 1055 N 300 W, Ste 401, Provo, UT 84604 Phone: 801-357-7499 Fax: 801-373-5980 | |
Kimberly A Brauer, AUD Audiologist Medicare: Not Enrolled in Medicare Practice Location: 3303 N University Ave, Provo, UT 84604 Phone: 801-373-7438 Fax: 013-737-4868 |