Ivan D Flint Md Pc | |
1250 E 3900 S Ste 450 Slc UT 84124-1349 | |
(801) 262-3600 | |
(801) 206-2555 |
Full Name | Ivan D Flint Md Pc |
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Speciality | Clinic/Center |
Location | 1250 E 3900 S Ste 450, Slc, Utah |
Authorized Official Name and Position | Ivan D Flint (MD/ PRESIDENT) |
Authorized Official Contact | 8012623600 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Ivan D Flint Md Pc 1250 E 3900 S Ste 450 Slc UT 84124-1349 Ph: (801) 262-3600 | Ivan D Flint Md Pc 1250 E 3900 S Ste 450 Slc UT 84124-1349 Ph: (801) 262-3600 |
NPI Number | 1821271529 |
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Provider Enumeration Date | 12/17/2007 |
Last Update Date | 12/17/2007 |
Medicare PECOS PAC ID | 9830128222 |
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Medicare Enrollment ID | O20050805000563 |
Identifier | Type | State | Issuer |
---|---|---|---|
1821271529 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 3200011205 (Utah) | Primary |
Provider Name | Ivan D Flint |
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Provider Type | Practitioner - Dermatology |
Provider Identifiers | NPI Number: 1962484485 PECOS PAC ID: 0941239743 Enrollment ID: I20060116000215 |
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