| Beaver Medical, Llc | |
|
1059 N 100 W Beaver UT 84713-1690 | |
| (435) 438-7280 | |
| (435) 438-7210 |
| Full Name | Beaver Medical, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1059 N 100 W, Beaver, Utah |
| Authorized Official Name and Position | Julie Christensen (OFFICE MANAGER) |
| Authorized Official Contact | 4354387280 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beaver Medical, Llc Po Box 1690 Beaver UT 84713-1690 Ph: (435) 438-7280 | Beaver Medical, Llc 1059 N 100 W Beaver UT 84713-1690 Ph: (435) 438-7280 |
| NPI Number | 1770570202 |
|---|---|
| Provider Enumeration Date | 09/30/2005 |
| Last Update Date | 11/16/2016 |
| Medicare PECOS PAC ID | 2365352036 |
|---|---|
| Medicare Enrollment ID | O20050714000791 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770570202 | NPI | - | NPPES |
| CG2421 | Other | UT | PALMETTO RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 47255720160 (Utah) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Richard Wade Oakden |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346245438 PECOS PAC ID: 9537079207 Enrollment ID: I20050323001233 |
| Provider Name | Roger Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043217268 PECOS PAC ID: 6800706573 Enrollment ID: I20051025000519 |
| Provider Name | Rebecca S Rasmusson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083755342 PECOS PAC ID: 8921014903 Enrollment ID: I20060228000598 |
| Provider Name | Wade Hollingshead |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962438895 PECOS PAC ID: 4183628092 Enrollment ID: I20060907000524 |
| Provider Name | Lance C Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295817708 PECOS PAC ID: 0244239374 Enrollment ID: I20061218000542 |
| Provider Name | Lindsay A Cheney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972747269 PECOS PAC ID: 2860544483 Enrollment ID: I20090713000523 |
| Provider Name | Robin R Horton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043650054 PECOS PAC ID: 4688817273 Enrollment ID: I20140613000791 |
| Provider Name | Rhett Roger Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568800209 PECOS PAC ID: 6305067141 Enrollment ID: I20141021001210 |
| Provider Name | Ryan White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770039356 PECOS PAC ID: 9537457403 Enrollment ID: I20161007001412 |
| Provider Name | Joan Lee Yardley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740750561 PECOS PAC ID: 5799018040 Enrollment ID: I20190531001724 |
| Provider Name | Zachary S Flinders |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760941090 PECOS PAC ID: 7012333131 Enrollment ID: I20200819001675 |
Robert L Smith Dc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 60 N Main St, Beaver, UT 84713 Phone: 435-438-6007 Fax: 435-438-6007 |