| Dustin Todd Bradley, | |
|
808 W 300 N, Vernal, UT 84078-3812 | |
| (435) 828-2541 | |
| Not Available |
| Full Name | Dustin Todd Bradley |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 10 Years |
| Location | 808 W 300 N, Vernal, 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 |
|---|---|---|---|
| 1942684162 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 7562535-4406 (Utah) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Ashley Regional Medical Center | Vernal, UT | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Ashley Valley Physician Practice Llc | 4284683947 | 17 |
| Entity Name | Ashley Valley Physician Practice Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740482025 PECOS PAC ID: 4284683947 Enrollment ID: O20050119001166 |
| Entity Name | Ubmc Anesthesiology |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043643877 PECOS PAC ID: 4981833381 Enrollment ID: O20140205001393 |
| Mailing Address | Practice Location Address |
|---|---|
| Dustin Todd Bradley, 808 W 300 N, Vernal, UT 84078-3812 Ph: (435) 828-2541 | Dustin Todd Bradley, 808 W 300 N, Vernal, UT 84078-3812 Ph: (435) 828-2541 |
Shane Verl Theobald, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 151 W 200 N, Vernal, UT 84078 Phone: 435-781-1519 Fax: 435-781-1519 | |
Pauline Frome, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 3021 E 5000 S, Vernal, UT 84078 Phone: 435-790-1877 | |
Mr. Michael Arthur Hartman, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 151 W 200 N, Vernal, UT 84078 Phone: 435-789-3352 Fax: 435-781-6893 | |
Mr. Dee Lewis Bambrough, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 151 W 200 N, Vernal, UT 84078 Phone: 435-789-3342 Fax: 435-781-6893 | |
Edwin Bulloch, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 150 W 100 N, Vernal, UT 84078 Phone: 207-659-8810 |