| Bryce Dee Allred Md A Pc | |
|
3584 W 9000 S Suite 400 West Jordan UT 84088-5710 | |
| (801) 569-2456 | |
| (801) 569-2080 |
| Full Name | Bryce Dee Allred Md A Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3584 W 9000 S, West Jordan, Utah |
| Authorized Official Name and Position | Bryce Dee Allred (PRESIDENT) |
| Authorized Official Contact | 8015692456 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bryce Dee Allred Md A Pc 3584 W 9000 S Suite 400 West Jordan UT 84088-5710 Ph: (801) 569-2456 | Bryce Dee Allred Md A Pc 3584 W 9000 S Suite 400 West Jordan UT 84088-5710 Ph: (801) 569-2456 |
| NPI Number | 1366803736 |
|---|---|
| Provider Enumeration Date | 03/14/2016 |
| Last Update Date | 05/13/2016 |
| Medicare PECOS PAC ID | 0345151072 |
|---|---|
| Medicare Enrollment ID | O20210208002435 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366803736 | NPI | - | NPPES |
| 5295820700000 | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (Utah) | Primary |
| Provider Name | Bryce Dee Allred |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1548317589 PECOS PAC ID: 0042121782 Enrollment ID: I20050617001032 |
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