| Oak Hill Medical Group Llc | |
|
6781 N 2100 E Liberty UT 84310-4701 | |
| (435) 770-4673 | |
| (855) 965-0961 |
| Full Name | Oak Hill Medical Group Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 6781 N 2100 E, Liberty, Utah |
| Authorized Official Name and Position | Leisa Firth (CHIEF CORPORATE OFFICER) |
| Authorized Official Contact | 4357555906 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oak Hill Medical Group Llc 6781 N 2100 E Liberty UT 84310-4701 Ph: (435) 770-4673 | Oak Hill Medical Group Llc 6781 N 2100 E Liberty UT 84310-4701 Ph: (435) 770-4673 |
| NPI Number | 1164061370 |
|---|---|
| Provider Enumeration Date | 01/06/2020 |
| Last Update Date | 03/16/2020 |
| Medicare PECOS PAC ID | 5991134355 |
|---|---|
| Medicare Enrollment ID | O20200406001904 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164061370 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | (* (Not Available)) | Primary |
| Provider Name | Ronald Firth |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477562767 PECOS PAC ID: 3870666274 Enrollment ID: I20080717000736 |
| Provider Name | Cynthia Lynn Hazelwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922242262 PECOS PAC ID: 2163578436 Enrollment ID: I20090929000311 |