Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 9355 S 1300 E, Sandy, Utah |
Authorized Official Name and Position | Michael E Cobble (PHYSICIAN) |
Authorized Official Contact | 8016666650 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Po Box 980700 Park City UT 84098-0700 Ph: (801) 572-1616 | 9355 S 1300 E Sandy UT 84094-3135 Ph: (801) 572-1616 |
NPI Number | 1043324312 |
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Provider Enumeration Date | 08/17/2006 |
Last Update Date | 11/06/2019 |
Medicare PECOS PAC ID | 1759346968 |
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Medicare Enrollment ID | O20041130000564 |
Identifier | Type | State | Issuer |
---|---|---|---|
1043324312 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | 2625861205 (Utah) | Primary |
Provider Name | Michael Edward Cobble |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1992927834 PECOS PAC ID: 3375508583 Enrollment ID: I20041130000581 |
Vernon K. Liu Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 880 E 9400 S, Suite 102, Sandy, UT 84094 Phone: 801-576-1118 Fax: 801-576-1221 | |
Utah Gastroenterology Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10150 S Petunia Way Ste B, Sandy, UT 84092 Phone: 801-619-9000 | |