| Mr Devon E Dahlke, PA-C | |
|
630 E 1400 N Ste 150, Logan, UT 84341-2549 | |
| (435) 915-4465 | |
| (435) 514-4556 |
| Full Name | Mr Devon E Dahlke |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 22 Years |
| Location | 630 E 1400 N Ste 150, Logan, 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 |
|---|---|---|---|
| 1598866691 | NPI | - | NPPES |
| $$$$$$$$$ | Other | UT | CHAMPUS |
| 1598866691 | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | (NU) | Primary |
| 207PE0004X | Emergency Medicine - Emergency Medical Services | 5703274-1206 (Utah) | Secondary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Sterling Provider Group | 2264773373 | 52 |
| Sterling Provider Group | 2264773373 | 52 |
| Entity Name | Ihc Health Services Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1629260880 PECOS PAC ID: 1850209420 Enrollment ID: O20031105000079 |
| Entity Name | Sterling Provider Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1205300407 PECOS PAC ID: 2264773373 Enrollment ID: O20190417002084 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Devon E Dahlke, PA-C 740 S Woodruff Ave, Idaho Falls, ID 83401-5285 Ph: (208) 542-9111 | Mr Devon E Dahlke, PA-C 630 E 1400 N Ste 150, Logan, UT 84341-2549 Ph: (435) 915-4465 |
Adrienne Mcmaster, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2380 N 400 E Ste B, Logan, UT 84341 Phone: 435-752-5741 |
Mr. Tyson Anderson Cluff, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1350 N 500 E, Logan, UT 84341 Phone: 435-716-2800 |
Madison Rae Groberg, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 115 Golf Course Rd Ste E, Logan, UT 84321 Phone: 435-999-4059 |
Thomas W Price, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 500 E 1400 N, Logan, UT 84341 Phone: 435-716-5478 |
Jackson Cheal, PA-S Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1201 S Main St Ste 110, Logan, UT 84321 Phone: 435-565-6043 Fax: 435-220-2030 |
Benjamin Seale, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1350 N 500 E, Logan, UT 84341 Phone: 435-716-2800 |
Kelsey Thorne, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2245 N 400 E Ste 201, Logan, UT 84341 Phone: 435-787-7001 Fax: 801-216-8357 |