| Carepoint Inpatient Blue Sky Neurology Utah, Pllc | |
|
1200 E 3900 S Salt Lake City UT 84124-1300 | |
| (801) 268-7111 | |
| Not Available |
| Full Name | Carepoint Inpatient Blue Sky Neurology Utah, Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1200 E 3900 S, Salt Lake City, Utah |
| Authorized Official Name and Position | Deborah Smith (VICE PRESIDENT/GENERAL COUNSEL) |
| Authorized Official Contact | 3034362720 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carepoint Inpatient Blue Sky Neurology Utah, Pllc 5600 S Quebec St Ste 312a Greenwood Village CO 80111-2208 Ph: (303) 436-2727 | Carepoint Inpatient Blue Sky Neurology Utah, Pllc 1200 E 3900 S Salt Lake City UT 84124-1300 Ph: (801) 268-7111 |
| NPI Number | 1972163368 |
|---|---|
| Provider Enumeration Date | 06/18/2019 |
| Last Update Date | 06/18/2019 |
| Medicare PECOS PAC ID | 0648500306 |
|---|---|
| Medicare Enrollment ID | O20190923001584 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972163368 | NPI | - | NPPES |
| Provider Name | Jeffrey Wagner |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1033321914 PECOS PAC ID: 2769580075 Enrollment ID: I20070611000486 |
| Provider Name | Matthew R Grantz |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1134373665 PECOS PAC ID: 8426226432 Enrollment ID: I20110719000142 |
| Provider Name | Christopher Fanale |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1598776452 PECOS PAC ID: 6103803465 Enrollment ID: I20191031000399 |
| Provider Name | Robert Weir |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1821485863 PECOS PAC ID: 2163828682 Enrollment ID: I20210909000959 |
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