Dr Mark R Keeton, MD | |
5444 Green St, Murray, UT 84123-5632 | |
(801) 262-8120 | |
(801) 262-3897 |
Full Name | Dr Mark R Keeton |
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Gender | Male |
Speciality | Radiology - Diagnostic Radiology |
Location | 5444 Green St, Murray, Utah |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1972543023 | NPI | - | NPPES |
D4329 | Medicaid | UT |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2085R0202X | Radiology - Diagnostic Radiology | 328861-1205 (Utah) | Primary |
2085R0202X | Radiology - Diagnostic Radiology | M-10499 (Idaho) | Secondary |
Entity Name | Mountain Medical Physician Specialists Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1720035520 PECOS PAC ID: 5294639407 Enrollment ID: O20031120000357 |
Mailing Address | Practice Location Address |
---|---|
Dr Mark R Keeton, MD 5444 Green St, Murray, UT 84123-5632 Ph: (801) 262-8120 | Dr Mark R Keeton, MD 5444 Green St, Murray, UT 84123-5632 Ph: (801) 262-8120 |
Karen Anne Dittrich, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 5444 S. Green St., Murray, UT 84123 Phone: 801-262-8120 Fax: 801-262-3897 | |
Dr. Jonathan Scott Shakespear, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 5444 S. Green St., Murray, UT 84123 Phone: 801-262-8120 Fax: 801-262-3897 | |
Dr. Steven T Hunt, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 5444 Green St, Murray, UT 84123 Phone: 801-262-8120 Fax: 801-262-3572 | |
Dr. Cheryl Lynn Green, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 5444 Green St, Murray, UT 84123 Phone: 801-262-2647 Fax: 801-262-3897 | |
Dr. Ivan Petrovitch, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 5121 S Cottonwood St, Murray, UT 84107 Phone: 801-507-7000 | |
Brian Matthew Sheehan, MD Radiology Medicare: Medicare Enrolled Practice Location: 5323 S Woodrow St Ste 101, Murray, UT 84107 Phone: 801-313-7500 | |
Dr. Wendell C Johnson, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 5444 S. Green St., Murray, UT 84123 Phone: 801-262-2647 Fax: 801-262-3897 |