| Atlas Medical Aco Llc | |
|
258 S Main St Ste 210 Logan UT 84321-5768 | |
| (435) 999-9510 | |
| Not Available |
| Full Name | Atlas Medical Aco Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 258 S Main St Ste 210, Logan, Utah |
| Authorized Official Name and Position | Gregory Chad Mangum (OWNER) |
| Authorized Official Contact | 4355145646 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Atlas Medical Aco Llc 258 S Main St Ste 210 Logan UT 84321-5768 Ph: () - | Atlas Medical Aco Llc 258 S Main St Ste 210 Logan UT 84321-5768 Ph: (435) 999-9510 |
| NPI Number | 1790513109 |
|---|---|
| Provider Enumeration Date | 07/25/2024 |
| Last Update Date | 10/17/2024 |
| Medicare PECOS PAC ID | 1456885227 |
|---|---|
| Medicare Enrollment ID | O20241115002118 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790513109 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Ryan H Larsen |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1235224932 PECOS PAC ID: 3971525064 Enrollment ID: I20060104000144 |
| Provider Name | Brett Cardon Porter |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1134175037 PECOS PAC ID: 8628975463 Enrollment ID: I20060110000303 |
| Provider Name | Nathan D Broschinsky |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1467894998 PECOS PAC ID: 7719114537 Enrollment ID: I20131223001611 |
| Provider Name | Jacob Brian Sanderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265094742 PECOS PAC ID: 3971834441 Enrollment ID: I20191015000287 |
| Provider Name | Carla Knighton Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588297360 PECOS PAC ID: 6901236868 Enrollment ID: I20200417001337 |
| Provider Name | Alexander Doxey |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1295265528 PECOS PAC ID: 4688943426 Enrollment ID: I20200619001912 |
| Provider Name | Miranda Paulsen Buttars |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144913344 PECOS PAC ID: 1153781695 Enrollment ID: I20230717000668 |
Ihc Health Services Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1281 N 600 E, Logan, UT 84341 Phone: 435-716-1130 | |
Midtown Community Health Center Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 550 E 1400 N Ste Xy, Logan, UT 84341 Phone: 801-393-5355 Fax: 801-394-4609 | |
Ihc Health Services Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 550 E 1400 N Ste Xy, Logan, UT 84341 Phone: 435-757-1315 | |
Family Eye Care Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 981 S Main St Ste 220, Logan, UT 84321 Phone: 435-363-2980 Fax: 435-514-0075 | |
Bridge Utah Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1015 E 100 N, Logan, UT 84321 Phone: 888-221-0423 Fax: 888-221-9816 | |
Corey B Johnson Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1219 N 400 E, Logan, UT 84341 Phone: 435-753-2842 | |
Ihc Health Services Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1350 N 500 E, Logan, UT 84341 Phone: 435-752-0422 |