| |
1784 Uinta Way Unit E2 Park City UT 84098-7685 | |
(617) 571-3680 | |
(435) 731-8328 |
Full Name | |
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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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50 W Broadway Ste 333 Salt Lake City UT 84101-2027 Ph: (435) 800-5711 | 1784 Uinta Way Unit E2 Park City UT 84098-7685 Ph: (617) 571-3680 |
NPI Number | 1104699446 |
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Provider Enumeration Date | 10/30/2023 |
Last Update Date | 12/26/2023 |
Medicare PECOS PAC ID | 6002265568 |
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Medicare Enrollment ID | O20231208001484 |
Identifier | Type | State | Issuer |
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1104699446 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Jennifer A. Knepper |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1437196144 PECOS PAC ID: 5799740361 Enrollment ID: I20150930000633 |
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 | |
Jupiter Medical I Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1784 Uinta Way Unit E2, Park City, UT 84098 Phone: 435-604-0160 Fax: 435-731-8328 | |
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 |