Dr Jason S Beales, MD | |
210 W 300 N 75-3, Roosevelt, UT 84066 | |
(435) 722-3971 | |
(435) 722-6104 |
Full Name | Dr Jason S Beales |
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Gender | Male |
Speciality | Pediatrics |
Location | 210 W 300 N 75-3, Roosevelt, Utah |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1891755872 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 53066341205 (Utah) | Primary |
Entity Name | Uintah Basin Medical Center |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1871556217 PECOS PAC ID: 0244131944 Enrollment ID: O20040226000948 |
Entity Name | Northeastern Utah Medical Group |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1982664199 PECOS PAC ID: 2961496609 Enrollment ID: O20040414000471 |
Mailing Address | Practice Location Address |
---|---|
Dr Jason S Beales, MD 210 W 300 N 75-3, Roosevelt, UT 84066 Ph: (435) 722-3971 | Dr Jason S Beales, MD 210 W 300 N 75-3, Roosevelt, UT 84066 Ph: (435) 722-3971 |
Dr. Shannon R Staker, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 210 W 300 N 75-3, Roosevelt, UT 84066 Phone: 435-722-3971 Fax: 435-722-6104 | |
Kyler Black, M.D. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 250 W 300 N, Roosevelt, UT 84066 Phone: 435-722-4691 |