| Dr James R Revenaugh, MD | |
|
5169 Cottonwood St, Bldg. B, Suite 520, Murray, UT 84107-6767 | |
| (801) 507-3500 | |
| (801) 507-3550 |
| Full Name | Dr James R Revenaugh |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine - Cardiovascular Disease |
| Location | 5169 Cottonwood St, Murray, Utah |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316915952 | NPI | - | NPPES |
| 002084158 | Medicaid | NV | |
| 805051500 | Medicaid | ID | |
| D1851 | Medicaid | UT | |
| 060052374 | Other | RR MEDICARE | |
| 113027700 | Medicaid | WY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RC0000X | Internal Medicine - Cardiovascular Disease | 333439 (Utah) | Primary |
| Entity Name | Ihc Health Services Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1629260880 PECOS PAC ID: 1850209420 Enrollment ID: O20031105000079 |
| Entity Name | Ihc Health Services Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1942325154 PECOS PAC ID: 1850209420 Enrollment ID: O20080610000303 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr James R Revenaugh, MD 5169 Cottonwood St, Bldg. B, Suite 520, Murray, UT 84107-6767 Ph: (801) 507-3500 | Dr James R Revenaugh, MD 5169 Cottonwood St, Bldg. B, Suite 520, Murray, UT 84107-6767 Ph: (801) 507-3500 |
Bogdan Ciprian Anea, MD Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: Intermountain Kidney Services Clinic, 5169 South Cottonwood Street, Suite 320, Murray, UT 84107 Phone: 801-507-2531 Fax: 801-507-2597 | |
Dr. Samah Bassas, MD Cardiovascular Disease Medicare: Not Enrolled in Medicare Practice Location: 1278 E Darby Cir, Murray, UT 84117 Phone: 801-228-7228 | |
E Dennis Genebach, MD Cardiovascular Disease Medicare: Not Enrolled in Medicare Practice Location: 5801 Fashion Blvd, Murray, UT 84107 Phone: 801-314-4544 | |
Dr. Tomoki Sempokuya, M.D. Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 5171 S Cottonwood St Ste 210, Murray, UT 84107 Phone: 801-507-3380 | |
Richa Parag Sheth, MD Cardiovascular Disease Medicare: Medicare Enrolled Practice Location: 5121 S Cottonwood St, Murray, UT 84107 Phone: 801-507-7000 | |
Dr. Samuel Morris Brown, MD Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 5121 S Cottonwood St, Murray, UT 84107 Phone: 801-507-6415 | |
Dr. Jamie Lynn Rebman, MD Cardiovascular Disease Medicare: Medicare Enrolled Practice Location: 5121 Cottonwood Rd, Suite 610, Murray, UT 84107 Phone: 801-507-3630 Fax: 801-507-3630 |