Thomas A Dickinson, MD | |
1055 N 500 W, Suite 100 Bldg B, Provo, UT 84604-3305 | |
(801) 374-1268 | |
(801) 812-5454 |
Full Name | Thomas A Dickinson |
---|---|
Gender | Male |
Speciality | Internal Medicine - Gastroenterology |
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 |
---|---|---|---|
1376591354 | NPI | - | NPPES |
100002620 | Other | UT | PALMETTO GBA |
29-00040 | Other | UT | UNITED HEALTHCARE |
107006219101 | Other | UT | IHC HEALTHPLANS |
0049 | Other | UT | DMBA |
QM0000009178 | Other | UT | ALTIUS |
5285 | Other | UT | PEHP |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RG0100X | Internal Medicine - Gastroenterology | 1660021205 (Utah) | Primary |
Entity Name | Central Utah Clinic Pc |
---|---|
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 |
---|---|
Thomas A Dickinson, MD 1055 N 500 W, Credentialing Department, Provo, UT 84604-3305 Ph: (801) 354-8225 | Thomas A Dickinson, MD 1055 N 500 W, Suite 100 Bldg B, Provo, UT 84604-3305 Ph: (801) 374-1268 |
Dr. Christopher Gordon, D.O. Gastroenterology Medicare: Accepting Medicare Assignments Practice Location: 745 N 500 W Ste 200, Provo, UT 84601 Phone: 801-375-9292 Fax: 801-375-9290 | |
Daniel N. Bennett, MD Gastroenterology Medicare: Accepting Medicare Assignments Practice Location: 1055 N 500 W, Ste 101, Building C, Provo, UT 84604 Phone: 801-373-4366 | |
Dr. Christopher Ryan Lew, DO Gastroenterology Medicare: Medicare Enrolled Practice Location: 1034 N 500 W, Provo, UT 84604 Phone: 801-960-7558 | |
Albert Rivero, MD Gastroenterology Medicare: Accepting Medicare Assignments Practice Location: 1134 N 500 W Ste 101, Provo, UT 84604 Phone: 801-357-8310 | |
Dr. Wenshu Yu, MD Gastroenterology Medicare: Accepting Medicare Assignments Practice Location: 3650 N University Ave Ste 150, Provo, UT 84604 Phone: 801-818-1940 Fax: 801-818-1945 | |
William T. Stephenson Ii, M.D. Gastroenterology Medicare: Accepting Medicare Assignments Practice Location: 395 W Bulldog Blvd Ste 103, Provo, UT 84604 Phone: 801-357-8200 Fax: 801-357-8201 | |
Gregory E Craner, MD Gastroenterology Medicare: Not Enrolled in Medicare Practice Location: 1055 N 500 W, Suite 100 Bldg B, Provo, UT 84604 Phone: 801-374-1268 Fax: 801-429-8041 |