Mark Dale Johnson, MD | |
6321 S Redwood Rd, Suite 201, Salt Lake City, UT 84123-6798 | |
(801) 265-2212 | |
(801) 265-0103 |
Full Name | Mark Dale Johnson |
---|---|
Gender | Male |
Speciality | Family Practice |
Experience | 35 Years |
Location | 6321 S Redwood Rd, Salt Lake City, 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 |
---|---|---|---|
1184668659 | NPI | - | NPPES |
529190498001 | Medicaid | UT |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 182573-1205 (Utah) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Caregiver Support Network Hospice | Kaysville, UT | Hospice |
South Davis Hospice | Bountiful, UT | Hospice |
Intermountain Medical Center | Murray, UT | Hospital |
St Mark's Hospital | Salt lake city, UT | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Jordan Ridge Family Medicine Llc | 8820091473 | 14 |
Entity Name | Jordan Ridge Family Medicine Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1770509754 PECOS PAC ID: 8820091473 Enrollment ID: O20060821000255 |
Mailing Address | Practice Location Address |
---|---|
Mark Dale Johnson, MD Po Box 35380, Las Vegas, NV 89133-5380 Ph: (801) 265-2212 | Mark Dale Johnson, MD 6321 S Redwood Rd, Suite 201, Salt Lake City, UT 84123-6798 Ph: (801) 265-2212 |
Dr. Roy Lewis James, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 675 E 2100 S, Suite 390, Salt Lake City, UT 84106 Phone: 800-366-1884 Fax: 801-487-8197 | |
Cynthia M Mathewson, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1525 W 2100 S, Salt Lake City, UT 84119 Phone: 801-887-2400 | |
Peter Thompson Weir, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 555 Foothill Dr, Salt Lake City, UT 84112 Phone: 801-585-5382 | |
Lisa J Hill, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 6556 S Big Cottonwood Canyon Rd Ste 500a, Salt Lake City, UT 84121 Phone: 385-246-1117 Fax: 385-246-1117 | |
Amy Noel De La Garza, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 807 E South Temple Ste 101, Salt Lake City, UT 84102 Phone: 801-369-8989 Fax: 801-704-9741 | |
Dr. Laura M. Yeater, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 375 S Chipeta Way Ste A, Salt Lake City, UT 84108 Phone: 801-587-3411 Fax: 801-581-2771 | |
Ms. Shannon B. Mckim, DO Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 375 S Chipeta Way Rm 201, Salt Lake City, UT 84108 Phone: 801-581-2121 |