| Spencer J Hardenbrook Md Pc | |
|
12176 S 1000 E Ste 4 Draper UT 84020-3221 | |
| (800) 640-3451 | |
| (385) 287-1900 |
| Full Name | Spencer J Hardenbrook Md Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 12176 S 1000 E Ste 4, Draper, Utah |
| Authorized Official Name and Position | Mariana Anderson Hankins (ADMINISTRATOR) |
| Authorized Official Contact | 8018881140 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Spencer J Hardenbrook Md Pc Po Box 1200 Pleasant Grove UT 84062-1200 Ph: (800) 640-3451 | Spencer J Hardenbrook Md Pc 12176 S 1000 E Ste 4 Draper UT 84020-3221 Ph: (800) 640-3451 |
| NPI Number | 1073909594 |
|---|---|
| Provider Enumeration Date | 04/10/2015 |
| Last Update Date | 11/06/2024 |
| Medicare PECOS PAC ID | 2062733546 |
|---|---|
| Medicare Enrollment ID | O20150609002364 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073909594 | NPI | - | NPPES |
| 08121980 | Other | OWNERS DOB |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 88335211205 (Utah) | Primary |
| Provider Name | Spencer James Hardenbrook |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881952315 PECOS PAC ID: 5092968685 Enrollment ID: I20150609002795 |
| Provider Name | Sandra Robles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356952840 PECOS PAC ID: 9931529898 Enrollment ID: I20201014001147 |
| Provider Name | Tyson Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679233134 PECOS PAC ID: 6608261854 Enrollment ID: I20220324002566 |
| Provider Name | Jill Nicholson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649558479 PECOS PAC ID: 0042113441 Enrollment ID: I20220802002204 |
| Provider Name | Robert Daniel Warren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376961011 PECOS PAC ID: 0749412047 Enrollment ID: I20221122001272 |
| Provider Name | Tumu J Asuao |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124697214 PECOS PAC ID: 1052773652 Enrollment ID: I20230814003885 |
| Provider Name | Rachel Voss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750152260 PECOS PAC ID: 0941653372 Enrollment ID: I20240422003298 |
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