Kazan Ivan W Memorial Clinic is a medicare enrolled primary clinic (Clinic/center - Federally Qualified Health Center (fqhc)) in Escalante, Utah. The current practice location for Kazan Ivan W Memorial Clinic is 570 E Moqui Ln, Escalante, Utah. For appointments, you can reach them via phone at
(435) 826-4374. The mailing address for Kazan Ivan W Memorial Clinic is Po Box 303, Bicknell, Utah and phone number is (435) 425-3744.
Kazan Ivan W Memorial Clinic is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its
NPI number is 1568886000. This medical practice
accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at
(435) 826-4374.
Primary Care Clinic Profile
| Full Name | Kazan Ivan W Memorial Clinic |
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| Speciality | Clinic/Center |
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| Location | 570 E Moqui Ln, Escalante, Utah |
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| Authorized Official Name and Position | Evan Christensen (EXECUTIVE DIRECTOR) |
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| Authorized Official Contact | 4354253744 |
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| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
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Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Kazan Ivan W Memorial Clinic
Po Box 303
Bicknell
UT 84715-0303
Ph: (435) 425-3744 | Kazan Ivan W Memorial Clinic
570 E Moqui Ln
Escalante
UT 84726-0276
Ph: (435) 826-4374 |
NPI Details:
| NPI Number | 1568886000 |
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| Provider Enumeration Date | 02/04/2014 |
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| Last Update Date | 04/21/2021 |
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Medicare PECOS Information:
| Medicare PECOS PAC ID | 1254242233 |
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| Medicare Enrollment ID | O20140414001659 |
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Medical Identifiers
Medical identifiers for Kazan Ivan W Memorial Clinic such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1568886000 | NPI | - | NPPES |
| 000055193 | Other | UT | MEDICARE PART B - |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
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