| Foot & Ankle Center Of Cache Valley | |
|
435 N Gateway Dr Ste 801 Providence UT 84332-9004 | |
| (435) 787-1023 | |
| (435) 787-1883 |
| Full Name | Foot & Ankle Center Of Cache Valley |
|---|---|
| Speciality | Podiatrist |
| Location | 435 N Gateway Dr Ste 801, Providence, Utah |
| Authorized Official Name and Position | Daniel J Huff (OWNER) |
| Authorized Official Contact | 4357871023 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Foot & Ankle Center Of Cache Valley 435 N Gateway Dr Ste 801 Providence UT 84332-9004 Ph: (435) 787-1023 | Foot & Ankle Center Of Cache Valley 435 N Gateway Dr Ste 801 Providence UT 84332-9004 Ph: (435) 787-1023 |
| NPI Number | 1750580643 |
|---|---|
| Provider Enumeration Date | 07/12/2007 |
| Last Update Date | 03/29/2023 |
| Medicare PECOS PAC ID | 5597857029 |
|---|---|
| Medicare Enrollment ID | O20070828000806 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750580643 | NPI | - | NPPES |
| 1437364445 | Medicaid | UT |
| Provider Name | Daniel J Huff |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1437364445 PECOS PAC ID: 0446342356 Enrollment ID: I20070925000033 |
| Provider Name | Ben Peter Boyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477703338 PECOS PAC ID: 4082760202 Enrollment ID: I20090914000126 |
| Provider Name | Tia Beth Peterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902277908 PECOS PAC ID: 8123328275 Enrollment ID: I20151123000989 |
| Provider Name | Benjamin A Thomas |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1043659055 PECOS PAC ID: 9638460843 Enrollment ID: I20160620000284 |
| Provider Name | James Thomas Willmore |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1770014516 PECOS PAC ID: 2163853961 Enrollment ID: I20200512000373 |
| Provider Name | Kimberly Lynn Tagg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801477286 PECOS PAC ID: 2860875143 Enrollment ID: I20220818003726 |
Mountainstar Cache Valley Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 382 W 280 N, Providence, UT 84332 Phone: 435-752-0330 Fax: 435-755-0922 | |
Health West Providence Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 517 W 100 N Ste 110, Providence, UT 84332 Phone: 435-213-4225 | |
Living Tree Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 169 N Gateway Dr Ste 170, Providence, UT 84332 Phone: 435-565-6043 Fax: 435-215-4420 | |
Cache Valley Community Health Center - Providence Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 517 W 100 N Ste 110, Providence, UT 84332 Phone: 435-755-6075 Fax: 435-994-8362 | |
Peachtree Family Medicine Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 565 W 465 N Ste 130, Providence, UT 84332 Phone: 435-752-5553 Fax: 435-755-5043 |