| Dr Jordan Russell Roberts, MD | |
|
999 E Murray Holladay Rd Ste 207, Holladay, UT 84117-5093 | |
| (801) 268-2584 | |
| (801) 262-1168 |
| Full Name | Dr Jordan Russell Roberts |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 10 Years |
| Location | 999 E Murray Holladay Rd Ste 207, Holladay, 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 |
|---|---|---|---|
| 1588043871 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 9897039-1205 (Utah) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Mark's Hospital | Salt lake city, UT | Hospital |
| Intermountain Medical Center | Murray, UT | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Granger Medical Clinic Pc | 3476465691 | 172 |
| Entity Name | Granger Medical Clinic Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1184657041 PECOS PAC ID: 3476465691 Enrollment ID: O20031105000159 |
| Entity Name | Utah Healthcare Institute Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1376597344 PECOS PAC ID: 7719882562 Enrollment ID: O20031204000492 |
| Entity Name | Granger Medical Specialists Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1376159368 PECOS PAC ID: 4587074356 Enrollment ID: O20201105002207 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Jordan Russell Roberts, MD 999 E Murray Holladay Rd Ste 207, Holladay, UT 84117-5093 Ph: (801) 268-2584 | Dr Jordan Russell Roberts, MD 999 E Murray Holladay Rd Ste 207, Holladay, UT 84117-5093 Ph: (801) 268-2584 |
Dr. Douglas Roland Smith, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 4544 S Holladay Blvd, Holladay, UT 84117 Phone: 801-682-6817 | |
Ajay Giri, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 4624 S Holladay Blvd, Holladay, UT 84117 Phone: 801-277-2682 Fax: 801-277-2980 |