| Red Tractor Family Medicine And Psychiatry | |
|
2610 W 12270 S Riverton UT 84065-7103 | |
| (801) 300-3329 | |
| Not Available |
| Full Name | Red Tractor Family Medicine And Psychiatry |
|---|---|
| Speciality | Family Medicine |
| Location | 2610 W 12270 S, Riverton, Utah |
| Authorized Official Name and Position | Georgia Allen (OWNER) |
| Authorized Official Contact | 8013003329 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Red Tractor Family Medicine And Psychiatry 2610 W 12270 S Riverton UT 84065-7103 Ph: () - | Red Tractor Family Medicine And Psychiatry 2610 W 12270 S Riverton UT 84065-7103 Ph: (801) 300-3329 |
| NPI Number | 1467107300 |
|---|---|
| Provider Enumeration Date | 02/18/2022 |
| Last Update Date | 07/30/2024 |
| Medicare PECOS PAC ID | 8527455104 |
|---|---|
| Medicare Enrollment ID | O20220429000086 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467107300 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Secondary |
| Provider Name | Georgia Talula Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972892396 PECOS PAC ID: 8224328885 Enrollment ID: I20160609002300 |
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