Lars Ulissey, is a
General Practice physician based in Hill Afb, Utah. Lars Ulissey is licensed to practice in California (license number A81520) and his current practice location is 7321 11th St, Bldg 569, Hill Afb, Utah. He can be reached at his office (for appointments etc.) via phone at
(801) 777-4710.
NPI number for Lars Ulissey is 1821087420 and his current mailing address is 5914 Highland Dr, Morgan, Utah. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1821087420.
Physician's Profile
| Full Name | Lars Ulissey |
|---|
| Gender | Male |
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| Speciality | General Practice |
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| Location | 7321 11th St, Hill Afb, Utah |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1821087420
- Provider Enumeration Date: 10/17/2005
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Lars Ulissey such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1821087420 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208D00000X | General Practice | A81520 (California) | Primary |
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. Lars Ulissey is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Lars Ulissey,
5914 Highland Dr,
Morgan, UT 84050-9758
Ph: () - | Lars Ulissey,
7321 11th St, Bldg 569,
Hill Afb, UT 84056-5012
Ph: (801) 777-4710 |
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