Nathaniel A Ptak, | |
5121 S Cottonwood St, Murray, UT 84107-5701 | |
(801) 507-7000 | |
Not Available |
Full Name | Nathaniel A Ptak |
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Gender | Male |
Speciality | Orthopaedic Surgery - Foot And Ankle Surgery |
Location | 5121 S Cottonwood St, Murray, Utah |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1194387571 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207XX0004X | Orthopaedic Surgery - Foot And Ankle Surgery | 12366058-0501 (Utah) | Primary |
Entity Name | The Southeast Permanente Medical Group |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1245266956 PECOS PAC ID: 6204829013 Enrollment ID: O20040407000370 |
Mailing Address | Practice Location Address |
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Nathaniel A Ptak, 5121 S Cottonwood St, Murray, UT 84107-5701 Ph: (630) 464-7825 | Nathaniel A Ptak, 5121 S Cottonwood St, Murray, UT 84107-5701 Ph: (801) 507-7000 |
Mitchell Rohrback, MD Orthopedic Surgery Medicare: Medicare Enrolled Practice Location: 5316 S Woodrow St Ste 200, Murray, UT 84107 Phone: 801-747-1020 | |
Yvonne Potter Fuellenbach, PA-C Orthopedic Surgery Medicare: Medicare Enrolled Practice Location: 5848 Fashion Blvd Ste 110, Murray, UT 84107 Phone: 801-314-4130 Fax: 801-314-4011 | |
Brian W Fukushima, MD Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 5316 S Woodrow St Ste 200, Murray, UT 84107 Phone: 801-747-1020 Fax: 801-747-1023 | |
Dr. Christopher Reid West, MD Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 5848 S Fashion Blvd Ste 120, Murray, UT 84107 Phone: 801-314-4900 Fax: 801-314-4919 | |
David Christopher Evans, MD Orthopedic Surgery Medicare: Medicare Enrolled Practice Location: 5316 S Woodrow St Ste 200, Murray, UT 84107 Phone: 801-747-1020 | |
Stephen Warner, MD Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 5323 South Woodrow Street, Suite 200, Murray, UT 84107 Phone: 801-747-1020 Fax: 801-747-1023 |