| Heather B Allred, PA-C | |
|
517 W 100 N Ste 103, Providence, UT 84332-9824 | |
| (435) 554-8442 | |
| (435) 500-9167 |
| Full Name | Heather B Allred |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 23 Years |
| Location | 517 W 100 N Ste 103, Providence, Utah |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104859149 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 5536681-1206 (Utah) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Intermountain Health Logan Regional Hospital | Logan, UT | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Lp Derm Llc | 9537533856 | 3 |
| Draper Dermatology Pc | 4688928526 | 6 |
| Entity Name | Rocky Mountain Dermatology Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154527372 PECOS PAC ID: 6002992906 Enrollment ID: O20080318000363 |
| Entity Name | Draper Dermatology PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093224818 PECOS PAC ID: 4688928526 Enrollment ID: O20181113002020 |
| Entity Name | LP Derm LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1538875786 PECOS PAC ID: 9537533856 Enrollment ID: O20230628003192 |
| Mailing Address | Practice Location Address |
|---|---|
| Heather B Allred, PA-C 3240 N 1800 E, Logan, UT 84341-8312 Ph: (801) 201-9151 | Heather B Allred, PA-C 517 W 100 N Ste 103, Providence, UT 84332-9824 Ph: (435) 554-8442 |
Amy Fisher, PA-C Physician Assistant Medicare: May Accept Medicare Assignments Practice Location: 286 N Gateway Dr Ste 201, Providence, UT 84332 Phone: 435-932-6125 |
Paul D. Mcomber, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 517 W 100 N Ste 110, Providence, UT 84332 Phone: 435-755-6075 Fax: 435-374-0502 |
Alexander Nathan Gerber, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 169 N Gateway Dr, Providence, UT 84332 Phone: 435-565-6043 |
Jalen Mon Tiev, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 412 Meadow Ln, Providence, UT 84332 Phone: 435-363-6400 |
Mrs. Candice Elizabeth Macari, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 169 N Gateway Dr Ste 175, Providence, UT 84332 Phone: 435-565-6043 Fax: 435-220-2030 |
Naomi Landry, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 517 W 100 N Ste 110, Providence, UT 84332 Phone: 435-755-6075 |
Matthew Stephen Morrell, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 595 W 465 N, Providence, UT 84332 Phone: 385-238-3900 Fax: 385-238-3901 |