Scott Taylor Jackson, MD | |
1055 N 500 W, Suite 121, Provo, UT 84604-3305 | |
(801) 373-7350 | |
(801) 812-5401 |
Full Name | Scott Taylor Jackson |
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Gender | Male |
Speciality | Orthopaedic Surgery |
Location | 1055 N 500 W, Provo, 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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1578666533 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207X00000X | Orthopaedic Surgery | 174144-1205 (Utah) | Primary |
Entity Name | Central Utah Clinic Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1093764805 PECOS PAC ID: 7517868508 Enrollment ID: O20040113000805 |
Mailing Address | Practice Location Address |
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Scott Taylor Jackson, MD 1055 N 500 W, Attn: Credentialing, Provo, UT 84604-3305 Ph: (801) 354-8225 | Scott Taylor Jackson, MD 1055 N 500 W, Suite 121, Provo, UT 84604-3305 Ph: (801) 373-7350 |
Travis A Peterson, DO Orthopedic Surgery Medicare: Medicare Enrolled Practice Location: 1055 N 500 W Ste 207, Provo, UT 84604 Phone: 801-375-4263 Fax: 801-429-8085 | |
Michael Callahan, MD Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 1055 N 500 W, Provo, UT 84604 Phone: 801-763-3885 Fax: 801-763-3887 | |
Jeffrey M Wallentine, MD Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 1055 N 500 W, Suite 121, Provo, UT 84604 Phone: 801-373-7350 Fax: 801-812-5401 | |
Dr. Trevor Shelton, M.D. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 1157 N 300 W, Provo, UT 84604 Phone: 801-357-1200 | |
Toby Johnson, MD Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 1055 N 500 W Ste 207, Provo, UT 84604 Phone: 801-373-7350 Fax: 801-429-8085 | |
Richard T Jackson, MD Orthopedic Surgery Medicare: Medicare Enrolled Practice Location: 1055 N 500 W, Suite 121, Provo, UT 84604 Phone: 801-373-7350 Fax: 801-812-5401 | |
Joshua Nelson Speirs, MD Orthopedic Surgery Medicare: Medicare Enrolled Practice Location: 1157 N 300 W Ste 302, Provo, UT 84604 Phone: 801-357-4470 Fax: 801-357-4473 |