| Advanced Family Medicine, Llc | |
|
619 S Bluff St Tower 1 Suite 100 St George UT 84770-3853 | |
| (435) 656-0234 | |
| (435) 656-2622 |
| Full Name | Advanced Family Medicine, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 619 S Bluff St, St George, Utah |
| Authorized Official Name and Position | Roger A Russell (CLINIC ADMINISTRATOR) |
| Authorized Official Contact | 4356560234 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Family Medicine, Llc 619 S Bluff St Tower 1 Suite 100 St George UT 84770-3853 Ph: (435) 656-0234 | Advanced Family Medicine, Llc 619 S Bluff St Tower 1 Suite 100 St George UT 84770-3853 Ph: (435) 656-0234 |
| NPI Number | 1639546377 |
|---|---|
| Provider Enumeration Date | 08/28/2015 |
| Last Update Date | 08/28/2015 |
| Medicare PECOS PAC ID | 2860701174 |
|---|---|
| Medicare Enrollment ID | O20151027000857 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639546377 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Dana B Hardin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053381558 PECOS PAC ID: 0345380606 Enrollment ID: I20091216000614 |
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