| Jacob White, | |
|
228 W 200 S Ste B, Kamas, UT 84036-9010 | |
| (435) 783-4385 | |
| Not Available |
| Full Name | Jacob White |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 3 Years |
| Location | 228 W 200 S Ste B, Kamas, 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 |
|---|---|---|---|
| 1841983384 | NPI | - | NPPES |
| 13526811-1206 | Other | UT | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | (* (Not Available)) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| University Of Utah Hospital And Clinics | Salt lake city, UT | Hospital |
| Intermountain Health Park City Hospital | Park city, UT | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| University Of Utah Community Physicians Group | 9739403569 | 277 |
| Entity Name | Gregory Iverson Family Medicine, PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1720379936 PECOS PAC ID: 4284804923 Enrollment ID: O20110907000943 |
| Entity Name | University of Utah Community Physicians Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1467241554 PECOS PAC ID: 9739403569 Enrollment ID: O20150126002118 |
| Mailing Address | Practice Location Address |
|---|---|
| Jacob White, 55 W 500 S, Heber City, UT 84032-2245 Ph: (801) 694-8425 | Jacob White, 228 W 200 S Ste B, Kamas, UT 84036-9010 Ph: (435) 783-4385 |
Mikenzie Hendricks, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 228 W 200 S, Kamas, UT 84036 Phone: 435-783-4385 |