Gordon Walter Duval, DO is a medicare enrolled "Pediatrics" physician in Tooele, Utah. His current practice location is
196 E 2000 N Ste 104, Tooele, Utah. You can reach out to his office (for appointments etc.) via phone at
(435) 882-9035.
Gordon Walter Duval is licensed to practice in Utah (license number 103604536-1204) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1619383304.
Physician's Profile
| Full Name | Gordon Walter Duval |
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| Gender | Male |
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| Speciality | Pediatrics |
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| Location | 196 E 2000 N Ste 104, Tooele, Utah |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1619383304
- Provider Enumeration Date: 07/02/2014
- Last Update Date: 10/13/2020
Medicare PECOS Information:
- PECOS PAC ID: 3274857099
- Enrollment ID: I20200913000018
Medical Identifiers
Medical identifiers for Gordon Walter Duval such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1619383304 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 208000000X | Pediatrics | 103604536-1204 (Utah) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Gordon Walter Duval allows following entities to bill medicare on his behalf.
| Entity Name | Tooele Clinic Corp |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1073512364 PECOS PAC ID: 6800700873 Enrollment ID: O20031113000800 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Gordon Walter Duval is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Gordon Walter Duval, DO Po Box 5009, Brentwood, TN 37024-5009 Ph: () - | Gordon Walter Duval, DO 196 E 2000 N Ste 104, Tooele, UT 84074-9335 Ph: (435) 882-9035 |
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