Jupiter Medical I Llc | |
1784 Uinta Way Unit E2 Park City UT 84098-7685 | |
(435) 604-0160 | |
(435) 731-8328 |
Full Name | Jupiter Medical I Llc |
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Speciality | Internal Medicine |
Location | 1784 Uinta Way Unit E2, Park City, Utah |
Authorized Official Name and Position | Bryan Knepper (OWNER) |
Authorized Official Contact | 6175713680 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Jupiter Medical I Llc 21 White Hill Rd Cold Spring Harbor NY 11724-1211 Ph: () - | Jupiter Medical I Llc 1784 Uinta Way Unit E2 Park City UT 84098-7685 Ph: (435) 604-0160 |
NPI Number | 1104346543 |
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Provider Enumeration Date | 06/27/2017 |
Last Update Date | 06/27/2017 |
Medicare PECOS PAC ID | 4486920568 |
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Medicare Enrollment ID | O20171017001896 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104346543 | NPI | - | NPPES |
U000092310 | Medicaid | UT |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (Utah) | Primary |
Anodyne Of Park City Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1790 Sun Peak Dr Ste A102, Park City, UT 84098 Phone: 435-640-1353 Fax: 435-655-2984 | |
Stat-md I Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1784 Uinta Way Unit E2, Park City, UT 84098 Phone: 435-604-0160 Fax: 435-731-8328 |