| Dr Brent E Wallace, MD | |
|
1915 W 5950 S, Roy, UT 84067-1454 | |
| (801) 387-8100 | |
| Not Available |
| Full Name | Dr Brent E Wallace |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 1915 W 5950 S, Roy, Utah |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124136221 | NPI | - | NPPES |
| 870348215008 | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 771610101205 (Utah) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Brent E Wallace, MD Po Box 27128, Salt Lake City, UT 84127-0128 Ph: (801) 387-8100 | Dr Brent E Wallace, MD 1915 W 5950 S, Roy, UT 84067-1454 Ph: (801) 387-8100 |
Kurtis Don Ellis, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1915 W 5950 S, Roy, UT 84067 Phone: 801-387-8100 Fax: 801-475-1621 | |
Diane Eh Wilson, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1937 W 5700 S, Roy, UT 84067 Phone: 801-773-9380 | |
Jared Don Hiatt, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1915 W 5950 S, Roy, UT 84067 Phone: 801-387-8100 | |
Kelly R Amann, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 3485 W 5200 S, Roy, UT 84067 Phone: 801-475-3900 Fax: 801-475-3901 | |
Dr. John R Wood, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1915 W 5950 S, Roy, UT 84067 Phone: 801-387-8100 | |
Dr. Isaac Samuel Sparks, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1915 W 5950 S, Family Medicine, Roy, UT 84067 Phone: 801-387-8100 Fax: 801-387-8223 |