| David Gordon Affleck, MD | |
|
1160 E 3900 S, Suite 3500, Salt Lake City, UT 84124-1202 | |
| (801) 743-4750 | |
| (801) 743-4765 |
| Full Name | David Gordon Affleck |
|---|---|
| Gender | Male |
| Speciality | Cardiac Surgery |
| Experience | 29 Years |
| Location | 1160 E 3900 S, Salt Lake City, Utah |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710979653 | NPI | - | NPPES |
| D5506 | Medicaid | UT | |
| P00424176 | Other | UT | RR MEDICARE |
| 134332141 | Other | UT | TAX IDENTIFICATION |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2086S0129X | Surgery - Vascular Surgery | 346120-1206 (Utah) | Secondary |
| 208G00000X | Thoracic Surgery (cardiothoracic Vascular Surgery) | 3461201205 (Utah) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Mark's Hospital | Salt lake city, UT | Hospital |
| Ogden Regional Medical Center | Ogden, UT | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Mountainstar Cardiovascular Services Llc | 1951404110 | 12 |
| Entity Name | Mountainstar Cardiovascular Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1689721219 PECOS PAC ID: 1951404110 Enrollment ID: O20070309000071 |
| Mailing Address | Practice Location Address |
|---|---|
| David Gordon Affleck, MD Po Box 281490, Atlanta, GA 30384-1490 Ph: () - | David Gordon Affleck, MD 1160 E 3900 S, Suite 3500, Salt Lake City, UT 84124-1202 Ph: (801) 743-4750 |
Dr. Bruce Bennett Reid, MD Thoracic Surgery (Cardiothoracic Vascular Surgery) Medicare: Accepting Medicare Assignments Practice Location: 324 10th Ave, #154, Salt Lake City, UT 84103 Phone: 801-408-8666 | |
J Kent Thorne, MD Thoracic Surgery (Cardiothoracic Vascular Surgery) Medicare: Not Enrolled in Medicare Practice Location: 1160 E 3900 S, #3500, Salt Lake City, UT 84124 Phone: 801-743-4750 Fax: 801-743-4765 | |
Michael P Collins, MD Thoracic Surgery (Cardiothoracic Vascular Surgery) Medicare: Medicare Enrolled Practice Location: 5169 S Cottonwood St, Ste 600, Salt Lake City, UT 84107 Phone: 801-507-3600 | |
Lauren E. Levy, MD Thoracic Surgery (Cardiothoracic Vascular Surgery) Medicare: Medicare Enrolled Practice Location: 30 N Mario Capecchi Drive Rm 4s100, Salt Lake City, UT 84132 Phone: 801-581-2121 | |
Dr. Stephen Eugene Clayson, MD Thoracic Surgery (Cardiothoracic Vascular Surgery) Medicare: Medicare Enrolled Practice Location: 324 10th Ave, Salt Lake City, UT 84103 Phone: 801-408-8666 | |
Hiroshi Kagawa, Thoracic Surgery (Cardiothoracic Vascular Surgery) Medicare: Accepting Medicare Assignments Practice Location: 50 N Medical Dr, Salt Lake City, UT 84132 Phone: 801-581-2353 | |
Edwin Clifford Mcgough, MD Thoracic Surgery (Cardiothoracic Vascular Surgery) Medicare: Medicare Enrolled Practice Location: 705 N Pioneer Fork Rd, Salt Lake City, UT 84108 Phone: 801-554-9481 |