| L Kristin Shadow, MD | |
|
50 N Medical Dr, Salt Lake City, UT 84132-0100 | |
| (801) 581-7951 | |
| Not Available |
| Full Name | L Kristin Shadow |
|---|---|
| Gender | Female |
| Speciality | Psychiatry & Neurology - Child & Adolescent Psychiatry |
| Location | 50 N Medical Dr, Salt Lake City, Utah |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922028497 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | 3282171205 (Utah) | Primary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 328217-1205 (Utah) | Secondary |
| Entity Name | Uhs Of Provo Canyon Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1457617409 PECOS PAC ID: 8729250543 Enrollment ID: O20121015000587 |
| Entity Name | University Of Utah Behavioral Health Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740688613 PECOS PAC ID: 9537483607 Enrollment ID: O20150120001118 |
| Mailing Address | Practice Location Address |
|---|---|
| L Kristin Shadow, MD Po Box 413029, Salt Lake City, UT 84141-3029 Ph: (801) 213-3900 | L Kristin Shadow, MD 50 N Medical Dr, Salt Lake City, UT 84132-0100 Ph: (801) 581-7951 |
Dr. Eric Thayne Monson, MD, PHD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 501 S Chipeta Way, Salt Lake City, UT 84108 Phone: 801-581-4096 | |
Dr. Gerald Martin Lazar, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 2005 E 2700 S, Suite 180, Salt Lake City, UT 84109 Phone: 801-746-2297 Fax: 801-322-3890 | |
Leah M. Fortson, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: Huntsman Mental Health Institute, 501 Chipeta Way, Salt Lake City, UT 84108 Phone: 801-581-4096 | |
Christopher R. Sweeney, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 501 S Chipeta Way, Salt Lake City, UT 84108 Phone: 801-581-7951 Fax: 801-581-5604 | |
Norman L. Foster, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 50 N Medical Dr, Salt Lake City, UT 84132 Phone: 801-585-6387 | |
Dr. Amy Gallop Weagley, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 501 S Chipeta Way, Salt Lake City, UT 84108 Phone: 801-581-2121 | |
Lawrence H Climo, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: Comphealth 4021 South 700 East, Suite 300, Salt Lake City, UT 84107 Phone: 800-453-3030 |