Uintah & Ouray Health Center | |
6822 East 1000 South Fort Duchesne UT 84026 | |
(435) 828-5214 | |
Not Available |
Full Name | Uintah & Ouray Health Center |
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Speciality | Clinic/Center |
Location | 6822 East 1000 South, Fort Duchesne, Utah |
Authorized Official Name and Position | Steve Pehrson (ACTING CEO) |
Authorized Official Contact | 4358285214 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Uintah & Ouray Health Center Po Box 160 Fort Duchesne UT 84026-0160 Ph: () - | Uintah & Ouray Health Center 6822 East 1000 South Fort Duchesne UT 84026 Ph: (435) 828-5214 |
NPI Number | 1518244086 |
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Provider Enumeration Date | 11/10/2011 |
Last Update Date | 11/10/2011 |
Medicare PECOS PAC ID | 6608199880 |
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Medicare Enrollment ID | O20141218001909 |
Identifier | Type | State | Issuer |
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1518244086 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP0904X | Clinic/center - Public Health, Federal | (* (Not Available)) | Primary |
Provider Name | Dwight R Humpherys |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1740293968 PECOS PAC ID: 1153385398 Enrollment ID: I20041117000189 |
Provider Name | Jonathan Jaksha |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1871555649 PECOS PAC ID: 3274632054 Enrollment ID: I20090904000224 |
Provider Name | Thomas Allred |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1639288855 PECOS PAC ID: 3274622444 Enrollment ID: I20100205000650 |
Provider Name | Jason Grennan |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1457313314 PECOS PAC ID: 9830179092 Enrollment ID: I20140812001681 |
Provider Name | Justin Ellis Costello |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1215235916 PECOS PAC ID: 5799054326 Enrollment ID: I20170925002292 |
Provider Name | Mohammed Quraishi |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1871545269 PECOS PAC ID: 8123030814 Enrollment ID: I20180404002328 |
Provider Name | Brian Gerald Myers |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1710062799 PECOS PAC ID: 7618946724 Enrollment ID: I20180416000496 |
Provider Name | Allison Summers |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1316926272 PECOS PAC ID: 1052366267 Enrollment ID: I20180820001492 |
Provider Name | Steven Todd Mccormack |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1023000338 PECOS PAC ID: 4183651987 Enrollment ID: I20180914000083 |
Provider Name | Shawn T Stone |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1891040689 PECOS PAC ID: 6103103569 Enrollment ID: I20190111001262 |
Provider Name | David Scott Henley |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1770518128 PECOS PAC ID: 2769374032 Enrollment ID: I20190115000657 |
Provider Name | Raeleen Orme |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1689954505 PECOS PAC ID: 9830349653 Enrollment ID: I20210408002038 |
Provider Name | Eric Justin Sorensen |
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Provider Type | Practitioner - Dentist |
Provider Identifiers | NPI Number: 1346337714 PECOS PAC ID: 5496124331 Enrollment ID: I20221215000728 |
Fort Duchesne Phs Indian Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6822 East 1000 South, Fort Duchesne Phs Indian Health Center, Fort Duchesne, UT 84026 Phone: 435-722-5122 Fax: 435-722-9137 |