| Shelly Savage M D Llc | |
|
1900 N State St Provo UT 84604-1341 | |
| (801) 373-2001 | |
| (801) 373-4748 |
| Full Name | Shelly Savage M D Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1900 N State St, Provo, Utah |
| Authorized Official Name and Position | Shelly Savage (OWNER) |
| Authorized Official Contact | 8013732001 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shelly Savage M D Llc 1900 N State St Provo UT 84604-1341 Ph: (801) 373-2001 | Shelly Savage M D Llc 1900 N State St Provo UT 84604-1341 Ph: (801) 373-2001 |
| NPI Number | 1669652343 |
|---|---|
| Provider Enumeration Date | 11/09/2007 |
| Last Update Date | 02/03/2022 |
| Medicare PECOS PAC ID | 7315917697 |
|---|---|
| Medicare Enrollment ID | O20040727000178 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669652343 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 4775407-1205 (Utah) | Primary |
| Provider Name | Shelly L Savage |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194876078 PECOS PAC ID: 8123098407 Enrollment ID: I20040727000198 |
| Provider Name | Natalie K Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215190657 PECOS PAC ID: 8325232598 Enrollment ID: I20170206001880 |
| Provider Name | Brooke Tuttle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871014159 PECOS PAC ID: 4688946098 Enrollment ID: I20170821000311 |
| Provider Name | Haley Wilson Jackson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396248159 PECOS PAC ID: 7012249444 Enrollment ID: I20191104002377 |
| Provider Name | Necia Dalley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124670872 PECOS PAC ID: 5092120378 Enrollment ID: I20210218001912 |
| Provider Name | Julie Edwards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538828124 PECOS PAC ID: 2567855547 Enrollment ID: I20220216000284 |
| Provider Name | Ashley Christianson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194470070 PECOS PAC ID: 6103203443 Enrollment ID: I20220506001961 |
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