| Gregory Iverson Family Medicine Pllc | |
|
142 South 50 East Coalville UT 84017-0865 | |
| (435) 336-4403 | |
| (435) 336-5570 |
| Full Name | Gregory Iverson Family Medicine Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 142 South 50 East, Coalville, Utah |
| Authorized Official Name and Position | Gregory Dennis Iverson (FAMILY PHYSICIAN/MANAGING MEMBER) |
| Authorized Official Contact | 4353364403 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gregory Iverson Family Medicine Pllc Po Box 865 Coalville UT 84017-0865 Ph: (435) 336-4403 | Gregory Iverson Family Medicine Pllc 142 South 50 East Coalville UT 84017-0865 Ph: (435) 336-4403 |
| NPI Number | 1720379936 |
|---|---|
| Provider Enumeration Date | 04/21/2011 |
| Last Update Date | 11/30/2011 |
| Medicare PECOS PAC ID | 4284804923 |
|---|---|
| Medicare Enrollment ID | O20110907000943 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720379936 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 7261660-1204 (Utah) | Primary |
| Provider Name | Donald Wain Allen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942224050 PECOS PAC ID: 1456255207 Enrollment ID: I20031122000024 |
| Provider Name | Gregory D Iverson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962469395 PECOS PAC ID: 2163564931 Enrollment ID: I20100118000164 |
| Provider Name | Jaclyn J Piper-williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619353182 PECOS PAC ID: 3971813221 Enrollment ID: I20151117001403 |
| Provider Name | Tillie Borrelli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154872539 PECOS PAC ID: 6709161870 Enrollment ID: I20170403001043 |
| Provider Name | Melissa J Jinks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699850644 PECOS PAC ID: 6709983174 Enrollment ID: I20210928003539 |
| Provider Name | Rhonda D Schlegel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760147011 PECOS PAC ID: 6002299401 Enrollment ID: I20220817003850 |
| Provider Name | Sara A Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336927441 PECOS PAC ID: 5799133047 Enrollment ID: I20231127001745 |
Coalville Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 142 S 50 East Suite 102, Pob 865, Coalville, UT 84017 Phone: 435-336-4403 Fax: 435-336-5570 | |
Donald Wain Allen Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 142 South 50 East, Coalville, UT 84017 Phone: 435-336-4403 Fax: 435-336-5570 |