Sean Anthony Ponce, MD | |
3802 S 700 E, Salt Lake City, UT 84106-1182 | |
(801) 264-6004 | |
(801) 264-6098 |
Full Name | Sean Anthony Ponce |
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Gender | Male |
Speciality | Family Medicine - Addiction Medicine |
Location | 3802 S 700 E, 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 |
---|---|---|---|
1376577049 | NPI | - | NPPES |
1376577049 | Medicaid | UT |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207QA0401X | Family Medicine - Addiction Medicine | 4976571-1205 (Utah) | Primary |
Entity Name | Usa Vein Clinics Of Utah Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1225640717 PECOS PAC ID: 7719306604 Enrollment ID: O20200925001386 |
Mailing Address | Practice Location Address |
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Sean Anthony Ponce, MD 3802 S 700 E, Salt Lake City, UT 84106-1182 Ph: (801) 264-6004 | Sean Anthony Ponce, MD 3802 S 700 E, Salt Lake City, UT 84106-1182 Ph: (801) 264-6004 |
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 | |
Wesley J. Lewis, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 6360 S 3000 E, Ste 100, Salt Lake City, UT 84121 Phone: 801-365-1032 Fax: 801-365-1033 |