| Nathan Sanborn, PA | |
|
555 W Sr 164, Salem, UT 84653-8465 | |
| (801) 465-4896 | |
| (801) 465-3267 |
| Full Name | Nathan Sanborn |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 4 Years |
| Location | 555 W Sr 164, Salem, 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 |
|---|---|---|---|
| 1235861022 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 13074268-1206 (Utah) | Primary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Revere Health Pc | 7517868508 | 407 |
| Entity Name | Revere Health PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093764805 PECOS PAC ID: 7517868508 Enrollment ID: O20040113000805 |
| Mailing Address | Practice Location Address |
|---|---|
| Nathan Sanborn, PA 1055 N 500 W, Attn Credentialing, Provo, UT 84604-5015 Ph: (801) 354-8225 | Nathan Sanborn, PA 555 W Sr 164, Salem, UT 84653-8465 Ph: (801) 465-4896 |
Robert Wright, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 555 W Sr 164, Salem, UT 84653 Phone: 801-465-4896 |
Shawn Stephen Hill, MPAS Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 555 W Sr 164, Salem, UT 84653 Phone: 801-465-4813 Fax: 801-812-5433 |
Jason Eatough, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 555 W State Road 164, Salem, UT 84653 Phone: 801-465-4896 Fax: 801-465-0606 |
Jonathan D Nelson, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 555 W Sr 164, Salem, UT 84653 Phone: 801-465-4813 Fax: 801-812-5433 |
James Vance Dodds, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 555 W State Road 164, Salem, UT 84653 Phone: 385-265-6050 Fax: 801-465-3267 |
Whitney Mccoy, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 555 W Sr 164, Salem, UT 84653 Phone: 801-465-4896 Fax: 801-465-3267 |
Tye Frank Johnson, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 555 W Sr 164, Salem, UT 84653 Phone: 801-465-4896 Fax: 801-465-3267 |