| William Paul Berg, MD | |
|
4095 E Pony Express Pkwy Ste 1, Eagle Mountain, UT 84005-5531 | |
| (801) 429-8037 | |
| (801) 753-7476 |
| Full Name | William Paul Berg |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 4095 E Pony Express Pkwy Ste 1, Eagle Mountain, Utah |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437594421 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 18521 (Hawaii) | Secondary |
| 207Q00000X | Family Medicine | 11705830-1205 (Utah) | Primary |
| Entity Name | Hoola Lahui Hawaii |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245269976 PECOS PAC ID: 2860303021 Enrollment ID: O20031226000260 |
| Entity Name | Kau Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1144304338 PECOS PAC ID: 7416945548 Enrollment ID: O20040601000398 |
| Entity Name | Puna Community Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174777916 PECOS PAC ID: 1254479033 Enrollment ID: O20091116000523 |
| Entity Name | The Wahiawa Center For Community Health |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1992176283 PECOS PAC ID: 6608154182 Enrollment ID: O20161108001466 |
| Mailing Address | Practice Location Address |
|---|---|
| William Paul Berg, MD 1055 N 500 W, Attn: Credentialing, Provo, UT 84604-3305 Ph: (801) 354-8225 | William Paul Berg, MD 4095 E Pony Express Pkwy Ste 1, Eagle Mountain, UT 84005-5531 Ph: (801) 429-8037 |
Jodi Lyn Ott, FNP Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 3133 E Cedar Pass Rd, Eagle Mountain, UT 84005 Phone: 435-531-1066 | |
Steven Len Embley, D.O. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 4095 E Pony Express Pkwy, Eagle Mountain, UT 84005 Phone: 801-429-8037 Fax: 801-753-7476 | |
Parker Winfield Lemon, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 4095 E Pony Express Pkwy Ste 1, Eagle Mountain, UT 84005 Phone: 801-429-8037 Fax: 801-753-7476 | |
Jared Michael Roberts, Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 3943 E Pony Express Pkwy Ste 120, Eagle Mountain, UT 84005 Phone: 801-789-5566 Fax: 801-642-2941 |