| Brigham Internal Medicine | |
|
1050 South Medical Drive Suite 101 Brigham City UT 84302 | |
| (435) 538-1733 | |
| (435) 538-1752 |
| Full Name | Brigham Internal Medicine |
|---|---|
| Speciality | Internal Medicine |
| Location | 1050 South Medical Drive, Brigham City, Utah |
| Authorized Official Name and Position | John R Markeson (OWNER) |
| Authorized Official Contact | 4355381733 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brigham Internal Medicine 1050 South Medical Drive Suite 101 Brigham City UT 84302 Ph: (435) 538-1733 | Brigham Internal Medicine 1050 South Medical Drive Suite 101 Brigham City UT 84302 Ph: (435) 538-1733 |
| NPI Number | 1003246950 |
|---|---|
| Provider Enumeration Date | 11/13/2013 |
| Last Update Date | 02/14/2020 |
| Certification Date | 02/14/2020 |
| Medicare PECOS PAC ID | 5395975528 |
|---|---|
| Medicare Enrollment ID | O20140307000854 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003246950 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | John R Markeson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861503419 PECOS PAC ID: 2264471044 Enrollment ID: I20060107000075 |
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