| Mountain West Family Practice Llc | |
|
2356 N 400 E Suite 201 Tooele UT 84074 | |
| (435) 882-2350 | |
| (435) 882-2039 |
| Full Name | Mountain West Family Practice Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2356 N 400 E, Tooele, Utah |
| Authorized Official Name and Position | Blake Beazer (PRESIDENT) |
| Authorized Official Contact | 4358822350 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain West Family Practice Llc 2356 N 400 E Suite 201 Tooele UT 84074 Ph: (435) 882-2350 | Mountain West Family Practice Llc 2356 N 400 E Suite 201 Tooele UT 84074 Ph: (435) 882-2350 |
| NPI Number | 1770581605 |
|---|---|
| Provider Enumeration Date | 07/13/2005 |
| Last Update Date | 11/24/2020 |
| Medicare PECOS PAC ID | 6406813070 |
|---|---|
| Medicare Enrollment ID | O20041215000392 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770581605 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 2005172 (Utah) | Primary |
| Provider Name | Sergio O Abarca |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245238617 PECOS PAC ID: 2769449339 Enrollment ID: I20041217000125 |
| Provider Name | Blake R Beazer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073510012 PECOS PAC ID: 5395702963 Enrollment ID: I20041217000245 |
| Provider Name | Amanda L Sheffer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720632078 PECOS PAC ID: 6103154216 Enrollment ID: I20190828001405 |
| Provider Name | Brooke Ludwig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134750110 PECOS PAC ID: 6103257639 Enrollment ID: I20200515001914 |
| Provider Name | Dana Michelle Roach |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265050660 PECOS PAC ID: 9436573722 Enrollment ID: I20200720002167 |
Valley Family Medicine Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2376 N 400 E Ste 102, Tooele, UT 84074 Phone: 435-843-1225 Fax: 435-843-1228 | |
Oasis Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1929 Aaron Dr, Suite I, Tooele, UT 84074 Phone: 435-833-0229 Fax: 435-833-0231 | |
Spine And Posture Rehabilitation Of Tooele Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 300 S Main St, Suite 2, Tooele, UT 84074 Phone: 435-882-1621 Fax: 435-882-8267 | |
Tooele Clinic Corp Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1887 Aaron Dr Ste B, Tooele, UT 84074 Phone: 435-775-9973 Fax: 435-775-9985 | |
Granger Medical Clinic Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2356 N 400 E Ste 201, Tooele, UT 84074 Phone: 801-352-5900 Fax: 801-352-5914 | |
Ram C Sharma, Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 255 S 100 E, Tooele, UT 84074 Phone: 435-882-0424 Fax: 435-843-1511 | |
Blake R. Beazer, M.d., Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2356 N 400 E, Ste. 201, Tooele, UT 84074 Phone: 435-882-2350 Fax: 435-882-2039 |