Gordon Walter Duval, DO is a medicare enrolled "Pediatrics" physician in Tooele, Utah. His current practice location is
196 E 2000 N Ste 104, Tooele, Utah. You can reach out to his office (for appointments etc.) via phone at
(435) 882-9035.
Gordon Walter Duval is licensed to practice in Utah (license number 103604536-1204) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1619383304.
Physician's Profile
Full Name | Gordon Walter Duval |
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Gender | Male |
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Speciality | Pediatrics |
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Location | 196 E 2000 N Ste 104, Tooele, Utah |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1619383304
- Provider Enumeration Date: 07/02/2014
- Last Update Date: 10/13/2020
Medicare PECOS Information:
- PECOS PAC ID: 3274857099
- Enrollment ID: I20200913000018
Medical Identifiers
Medical identifiers for Gordon Walter Duval such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1619383304 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208000000X | Pediatrics | 103604536-1204 (Utah) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Gordon Walter Duval allows following entities to bill medicare on his behalf.
Entity Name | Tooele Clinic Corp |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1073512364 PECOS PAC ID: 6800700873 Enrollment ID: O20031113000800 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Gordon Walter Duval is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Gordon Walter Duval, DO Po Box 5009, Brentwood, TN 37024-5009 Ph: () - | Gordon Walter Duval, DO 196 E 2000 N Ste 104, Tooele, UT 84074-9335 Ph: (435) 882-9035 |
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