Wow Medical Llc | |
345 E Gateway Dr Ste 150 Heber City UT 84032-4625 | |
(435) 657-0101 | |
Not Available |
Full Name | Wow Medical Llc |
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Speciality | Family Medicine |
Location | 345 E Gateway Dr Ste 150, Heber City, Utah |
Authorized Official Name and Position | Isaac Button (MANAGER) |
Authorized Official Contact | 4803593129 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Wow Medical Llc 160 W Canyon Crest Rd Alpine UT 84004-1679 Ph: (480) 359-3120 | Wow Medical Llc 345 E Gateway Dr Ste 150 Heber City UT 84032-4625 Ph: (435) 657-0101 |
NPI Number | 1356913537 |
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Provider Enumeration Date | 07/15/2021 |
Last Update Date | 07/15/2021 |
Medicare PECOS PAC ID | 5991193526 |
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Medicare Enrollment ID | O20211101000305 |
Identifier | Type | State | Issuer |
---|---|---|---|
1356913537 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Jessica A Parker |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1972830768 PECOS PAC ID: 5799928842 Enrollment ID: I20130821000731 |
Provider Name | Cameryn Leigh Smith |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1376185322 PECOS PAC ID: 0749614725 Enrollment ID: I20211102002411 |
Provider Name | Crystal B Miller |
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Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
Provider Identifiers | NPI Number: 1598407991 PECOS PAC ID: 8527447754 Enrollment ID: I20220620000084 |
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