| Blaser Medical Llc | |
|
475 40th St Ste 111 Ogden UT 84403-1856 | |
| (801) 515-7997 | |
| (385) 333-7413 |
| Full Name | Blaser Medical Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 475 40th St Ste 111, Ogden, Utah |
| Authorized Official Name and Position | Elizabeth Ann Allison (CONTRACTING/CREDENTIALING) |
| Authorized Official Contact | 8013916617 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blaser Medical Llc 116 S Shadow Breeze Rd Kaysville UT 84037-9401 Ph: (801) 515-7997 | Blaser Medical Llc 475 40th St Ste 111 Ogden UT 84403-1856 Ph: (801) 515-7997 |
| NPI Number | 1023721941 |
|---|---|
| Provider Enumeration Date | 01/05/2023 |
| Last Update Date | 04/15/2024 |
| Medicare PECOS PAC ID | 0143694398 |
|---|---|
| Medicare Enrollment ID | O20230522000828 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023721941 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Brett Blaser |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538471313 PECOS PAC ID: 9830331321 Enrollment ID: I20150617000103 |
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