| Jeffrey W Johnson, MD | |
|
1055 N 500 W Ste 212, Provo, UT 84604-3305 | |
| (801) 374-2362 | |
| (801) 429-8196 |
| Full Name | Jeffrey W Johnson |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine |
| Location | 1055 N 500 W Ste 212, Provo, Utah |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285692400 | NPI | - | NPPES |
| 110037853 | Other | UT | PALMETTO GBA |
| 04-00467 | Other | UT | UNITED HEALTHCARE |
| 2556 | Other | UT | DMBA |
| QM0000000053 | Other | UT | ALTIUS |
| 107006671101 | Other | UT | IHC HEALTHPLANS |
| 16205 | Other | UT | PEHP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 1716591205 (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 | Central Utah Clinic Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093764805 PECOS PAC ID: 7517868508 Enrollment ID: O20040113000805 |
| Mailing Address | Practice Location Address |
|---|---|
| Jeffrey W Johnson, MD 1055 N 500 W, Attn: Credentialing, Provo, UT 84604-3305 Ph: (801) 354-8225 | Jeffrey W Johnson, MD 1055 N 500 W Ste 212, Provo, UT 84604-3305 Ph: (801) 374-2362 |
Dr. Christopher Gordon, D.O. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 745 N 500 W Ste 200, Provo, UT 84601 Phone: 801-375-9292 Fax: 801-375-9290 | |
Daniel N. Bennett, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1055 N 500 W, Ste 101, Building C, Provo, UT 84604 Phone: 801-373-4366 | |
Pace Romney, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1055 N 300 W Ste 210, Provo, UT 84604 Phone: 801-357-0280 | |
Dr. Christopher Ryan Lew, DO Internal Medicine Medicare: Medicare Enrolled Practice Location: 1034 N 500 W, Provo, UT 84604 Phone: 801-960-7558 | |
Albert Rivero, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1134 N 500 W Ste 101, Provo, UT 84604 Phone: 801-357-8310 | |
Dr. Wenshu Yu, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 3650 N University Ave Ste 150, Provo, UT 84604 Phone: 801-818-1940 Fax: 801-818-1945 | |
William T. Stephenson Ii, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 395 W Bulldog Blvd Ste 103, Provo, UT 84604 Phone: 801-357-8200 Fax: 801-357-8201 |