| Dr Jeremiah James Nielson, DO | |
|
750 W 800 N, Orem, UT 84057-3660 | |
| (801) 714-6000 | |
| Not Available |
| Full Name | Dr Jeremiah James Nielson |
|---|---|
| Gender | Male |
| Speciality | Pediatrics - Neonatal-perinatal Medicine |
| Location | 750 W 800 N, Orem, Utah |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699891374 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2080N0001X | Pediatrics - Neonatal-perinatal Medicine | 14196340-1234 (Utah) | Primary |
| 2080N0001X | Pediatrics - Neonatal-perinatal Medicine | O-1943 (Idaho) | Secondary |
| Entity Name | Pokroy Medical Group Of Nevada Ltd |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1992809412 PECOS PAC ID: 7911037643 Enrollment ID: O20100607000694 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Jeremiah James Nielson, DO 750 W 800 N, Orem, UT 84057-3660 Ph: (801) 714-6000 | Dr Jeremiah James Nielson, DO 750 W 800 N, Orem, UT 84057-3660 Ph: (801) 714-6000 |
Jonathen Bartholomew, DO Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 171 N 400 W, C12, Orem, UT 84057 Phone: 801-224-4550 Fax: 801-224-1057 | |
Ernest Andrew Bailey, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 716 W 800 N, Suite 300, Orem, UT 84057 Phone: 801-224-0421 Fax: 801-224-0821 | |
Dr. Dale R Gerstmann, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 750 W 800 N, Orem, UT 84057 Phone: 801-714-6511 Fax: 801-714-6597 | |
Dr. Dustin Edward Monroe, M.D., M.B.A. Pediatrics Medicare: Medicare Enrolled Practice Location: 750 W 800 N, Orem, UT 84057 Phone: 801-714-6350 | |
John R Wynn, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 171 N 400 W, C-12, Orem, UT 84057 Phone: 801-224-4550 Fax: 801-224-1057 | |
Sunit Kumar Misra, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 750 W 800 N, Orem, UT 84057 Phone: 909-996-9187 | |
Dr. Gregory Scott Wynn, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 716 W 800 N Ste 300, Orem, UT 84057 Phone: 801-224-0421 Fax: 801-224-0821 |