Dr Travis Brandon Charles, DO | |
555 W Sr 164, Salem, UT 84653 | |
(385) 265-6050 | |
(801) 465-3287 |
Full Name | Dr Travis Brandon Charles |
---|---|
Gender | Male |
Speciality | Family Practice |
Experience | 14 Years |
Location | 555 W Sr 164, Salem, 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 |
---|---|---|---|
1255643136 | NPI | - | NPPES |
840074 | Medicaid | AZ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 2010021663 (Missouri) | Secondary |
207Q00000X | Family Medicine | 006233 (Arizona) | Secondary |
207Q00000X | Family Medicine | 12403966-1204 (Utah) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Central Utah Clinic Pc | 7517868508 | 386 |
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 |
Mailing Address | Practice Location Address |
---|---|
Dr Travis Brandon Charles, DO 1055 N. 500 W Attn: Credentialing, Provo, UT 84604 Ph: (801) 354-8225 | Dr Travis Brandon Charles, DO 555 W Sr 164, Salem, UT 84653 Ph: (385) 265-6050 |
Gale J. Skousen, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 591 N State Road 198 Ste 203, Salem, UT 84653 Phone: 801-465-9802 | |
Dr. Jarrett Hammer, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 555 W State Road 164, Salem, UT 84653 Phone: 801-465-4896 Fax: 801-465-3267 | |
David Tipton, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 555 West Sr 164, Salem, UT 84653 Phone: 801-465-4896 Fax: 801-465-3267 | |
Dr. Jonathan Shumway, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 555 W Sr 164, Salem, UT 84653 Phone: 801-465-4896 Fax: 801-465-3267 |