| High Desert Neurology Of Utah, Pc | |
|
175 N 100 W Ste N104 Vernal UT 84078-2049 | |
| (385) 236-3876 | |
| (855) 933-2297 |
| Full Name | High Desert Neurology Of Utah, Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 175 N 100 W Ste N104, Vernal, Utah |
| Authorized Official Name and Position | Thomas Maurice Buchanan (OWNER) |
| Authorized Official Contact | 8018038591 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| High Desert Neurology Of Utah, Pc 175 N 100 W Ste N104 Vernal UT 84078-2049 Ph: (385) 236-3876 | High Desert Neurology Of Utah, Pc 175 N 100 W Ste N104 Vernal UT 84078-2049 Ph: (385) 236-3876 |
| NPI Number | 1720779416 |
|---|---|
| Provider Enumeration Date | 05/15/2023 |
| Last Update Date | 01/29/2024 |
| Certification Date | 01/29/2024 |
| Medicare PECOS PAC ID | 8729435193 |
|---|---|
| Medicare Enrollment ID | O20231107000037 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720779416 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Thomas M Buchanan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1710162227 PECOS PAC ID: 7517141088 Enrollment ID: I20110407000029 |
| Provider Name | Kathleen Marie Riordan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033984554 PECOS PAC ID: 8325481864 Enrollment ID: I20240212002336 |
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