Mark R Briesacher, MD | |
2180 E 4500 S, #210, Salt Lake City, UT 84117-4434 | |
(801) 278-4719 | |
Not Available |
Full Name | Mark R Briesacher |
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Gender | Male |
Speciality | Pediatrics |
Location | 2180 E 4500 S, Salt Lake City, Utah |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1154333029 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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208000000X | Pediatrics | 932637891205 (Utah) | Primary |
Entity Name | Ihc Health Services Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1942325154 PECOS PAC ID: 1850209420 Enrollment ID: O20080610000303 |
Mailing Address | Practice Location Address |
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Mark R Briesacher, MD Po Box 27128, Salt Lake City, UT 84127-0128 Ph: (801) 278-4719 | Mark R Briesacher, MD 2180 E 4500 S, #210, Salt Lake City, UT 84117-4434 Ph: (801) 278-4719 |
Kristina Mckinley, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: University Of Utah Hospital, 30 North 1900 East, Rm 1c412, Salt Lake City, UT 84132 Phone: 801-581-2401 | |
Kaitlin Carpenter, Pediatrics Medicare: Medicare Enrolled Practice Location: 100 Mario Capecchi Dr, Salt Lake City, UT 84113 Phone: 801-662-1000 | |
Dr. Thomas Patrick Curtin, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 81 N Mario Capecchi Dr, Salt Lake City, UT 84113 Phone: 801-662-5700 | |
Anastasiya Mankouski, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 5121 S Cottonwood St, Salt Lake City, UT 84107 Phone: 801-507-7000 | |
Joslynn Marie Hoburg, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 295 S Chipeta Way Rm 2s010, Salt Lake City, UT 84108 Phone: 801-581-2121 | |
George W Delavan, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 44 N Mario Capecchi Dr, Salt Lake City, UT 84132 Phone: 801-584-8239 Fax: 801-584-8588 | |
Michelle Ploutz, Pediatrics Medicare: Medicare Enrolled Practice Location: 100 N Mario Capecchi Dr, Salt Lake City, UT 84113 Phone: 801-662-1000 Fax: 018-213-7778 |