| Clinton D Olsen, DNP, NP-C | |
|
280 W River Park Dr, Suite 200, Provo, UT 84604-5793 | |
| (801) 223-4860 | |
| (801) 371-8993 |
| Full Name | Clinton D Olsen |
|---|---|
| Gender | Male |
| Speciality | Anesthesiology - Pain Medicine |
| Location | 280 W River Park Dr, Provo, Utah |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225387491 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207LP2900X | Anesthesiology - Pain Medicine | 66883094405 (Utah) | Primary |
| 207LP2900X | Anesthesiology - Pain Medicine | 66883098900 (Utah) | Secondary |
| Entity Name | Spinal Interventions, Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053336917 PECOS PAC ID: 3476513417 Enrollment ID: O20041014000518 |
| Mailing Address | Practice Location Address |
|---|---|
| Clinton D Olsen, DNP, NP-C 280 River Park Dr, Suite 200, Provo, UT 84604-5764 Ph: (801) 223-4860 | Clinton D Olsen, DNP, NP-C 280 W River Park Dr, Suite 200, Provo, UT 84604-5793 Ph: (801) 223-4860 |
Dr. Daniel Rey Faber, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 280 River Park Dr, #200, Provo, UT 84604 Phone: 801-223-4860 Fax: 801-371-8993 | |
John B Zimmerman, MD Anesthesiology Medicare: Medicare Enrolled Practice Location: 1034 North 500 West, Utah Valley Regional Medical Center, Provo, UT 84604 Phone: 801-507-5248 Fax: 801-733-5618 | |
David Groesbeck, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 1034 North 500 West, Utah Valley Regional Medical Center, Provo, UT 84604 Phone: 801-507-5248 Fax: 801-733-5618 | |
Carl Thayne Wilson, MD Anesthesiology Medicare: Medicare Enrolled Practice Location: 1034 North 500 West, Utah Valley Regional Medical Center, Provo, UT 84604 Phone: 801-507-5248 Fax: 801-733-5618 | |
Jeffrey David Poulsen, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1034 N 500 W, Provo, UT 84604 Phone: 801-357-7850 | |
Mr. Matthew David Wagaman, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1034 N 500 W, Provo, UT 84604 Phone: 801-357-7850 Fax: 770-701-6675 | |
Mitchell D Albrecht, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1034 N 500 W, Provo, UT 84004 Phone: 801-993-9582 Fax: 801-733-5618 |