Dr Peter Blaine Hathaway, MD | |
1433 N 1075 W Ste 104, Farmington, UT 84025-2746 | |
(801) 298-1300 | |
Not Available |
Full Name | Dr Peter Blaine Hathaway |
---|---|
Gender | Male |
Speciality | Diagnostic Radiology |
Experience | 31 Years |
Location | 1433 N 1075 W Ste 104, Farmington, Utah |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1730187824 | NPI | - | NPPES |
8067535 | Medicaid | ID | |
002089152 | Medicaid | NV | |
P00196218 | Other | UT | RR MEDICARE |
120828400 | Medicaid | WY | |
4456436 | Medicaid | CA | |
927733 | Medicaid | AZ | |
P00651533 | Other | UT | RR MEDICARE |
D2916 | Medicaid | UT |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2085R0202X | Radiology - Diagnostic Radiology | 372564-1205 (Utah) | Secondary |
2085R0204X | Radiology - Vascular & Interventional Radiology | 372564-1205 (Utah) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
St Mark's Hospital | Salt lake city, UT | Hospital |
Lone Peak Hospital | Draper, UT | Hospital |
Ogden Regional Medical Center | Ogden, UT | Hospital |
Lakeview Hospital | Bountiful, UT | Hospital |
Brigham City Community Hospital | Brigham city, UT | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Utah Imaging Associates Inc | 1355394537 | 42 |
Wasatch Vascular Center Llc | 1951726967 | 6 |
Entity Name | Central Utah Clinic Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1093764805 PECOS PAC ID: 7517868508 Enrollment ID: O20040113000805 |
Entity Name | Utah Imaging Associates Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1629076229 PECOS PAC ID: 1355394537 Enrollment ID: O20050228000845 |
Entity Name | Tooele Valley Imaging Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1699004499 PECOS PAC ID: 2466624630 Enrollment ID: O20111012000146 |
Entity Name | Oquirrh Radiology Associates Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1568734143 PECOS PAC ID: 4082875448 Enrollment ID: O20120411000273 |
Entity Name | Wasatch Vascular Center Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1558905398 PECOS PAC ID: 1951726967 Enrollment ID: O20200807002691 |
Entity Name | Green River Radiology Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1508533878 PECOS PAC ID: 5294123063 Enrollment ID: O20211027002062 |
Mailing Address | Practice Location Address |
---|---|
Dr Peter Blaine Hathaway, MD Po Box 25488, Salt Lake City, UT 84125-0488 Ph: (800) 475-3698 | Dr Peter Blaine Hathaway, MD 1433 N 1075 W Ste 104, Farmington, UT 84025-2746 Ph: (801) 298-1300 |
Dr. Cole Joseph Panushka, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1433 N 1075 W Ste 104, Farmington, UT 84025 Phone: 801-298-1300 Fax: 801-296-6199 | |
Dr. Christopher J. Parr, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1433 N 1075 W Ste 104, Farmington, UT 84025 Phone: 801-298-1300 Fax: 801-296-6199 | |
Dr. David Ray Dedrickson, M.D. Radiology Medicare: Medicare Enrolled Practice Location: 1433 N 1075 W, Ste 104, Farmington, UT 84025 Phone: 801-298-1300 Fax: 801-296-6199 | |
Dr. Jason Anthony Kirkham, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1433 N 1075 W Ste 104, Farmington, UT 84025 Phone: 801-298-1300 Fax: 801-296-6199 | |
Colin David Jones, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1433 N 1075 W Ste 104, Farmington, UT 84025 Phone: 801-298-1300 | |
Dr. Trenton Mcneil Wright, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1433 N 1075 W Ste 104, Farmington, UT 84025 Phone: 801-298-1300 Fax: 801-296-6199 | |
Dr. Craig Michael Carpenter, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 1433 N 1075 W Ste 104, Farmington, UT 84025 Phone: 801-298-1300 Fax: 801-296-6199 |