| Blue Rock Medical Center | |
|
3152 N University Ave Ste 100 Provo UT 84604-4729 | |
| (801) 229-2002 | |
| (801) 229-1003 |
| Full Name | Blue Rock Medical Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 3152 N University Ave Ste 100, Provo, Utah |
| Authorized Official Name and Position | Barbara Givens (OFFICE MANAGER) |
| Authorized Official Contact | 8012292002 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Rock Medical Center 3152 N University Ave Ste 100 Provo UT 84604-4729 Ph: (801) 229-2002 | Blue Rock Medical Center 3152 N University Ave Ste 100 Provo UT 84604-4729 Ph: (801) 229-2002 |
| NPI Number | 1649567504 |
|---|---|
| Provider Enumeration Date | 06/29/2011 |
| Last Update Date | 11/01/2012 |
| Medicare PECOS PAC ID | 7214161256 |
|---|---|
| Medicare Enrollment ID | O20131007001490 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649567504 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Joseph R Watkins |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1659396695 PECOS PAC ID: 9830091222 Enrollment ID: I20040126000303 |
| Provider Name | Karl Jay Barton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306889522 PECOS PAC ID: 0244206373 Enrollment ID: I20040909000330 |
| Provider Name | Wendell A Gibby |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1992802235 PECOS PAC ID: 5092799411 Enrollment ID: I20050617000209 |
| Provider Name | Matthew R Poulsen |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1881635761 PECOS PAC ID: 9830368638 Enrollment ID: I20110812000119 |
| Provider Name | Conrad Gibby |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1750624979 PECOS PAC ID: 3779832621 Enrollment ID: I20190521001303 |
| Provider Name | Wendell Gibby |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1487090528 PECOS PAC ID: 8123351269 Enrollment ID: I20190605001110 |
| Provider Name | Thomas H Fjeldsted |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699121277 PECOS PAC ID: 1456684638 Enrollment ID: I20210728003547 |
Thyroid Clinic Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1055 N 300 W Ste 315, Provo, UT 84604 Phone: 385-205-6510 Fax: 385-375-6112 | |
Ingegrative Medical Assicates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3650 N University Ave, Suite 200, Provo, UT 84604 Phone: 801-375-7100 Fax: 801-375-7102 | |
The Body Hackers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3210 N Canyon Rd Ste 307, Provo, UT 84604 Phone: 801-310-5385 | |
Utah Valley Specialty Hospital Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 306 River Bend Ln, Provo, UT 84604 Phone: 801-226-8880 | |
Atlas Epigenetics Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3311 N University Ave Ste 150, Provo, UT 84604 Phone: 801-655-1801 Fax: 385-225-8201 | |
Life Integrative Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 777 N 500 W, Suite 104, Provo, UT 84601 Phone: 801-869-8199 Fax: 801-705-0436 | |
Revere Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1055 N 500 W, Provo, UT 84604 Phone: 801-429-8000 Fax: 801-429-8150 |