| Desert Edge Medical | |
|
1664 S Dixie Dr Ste D201 St George UT 84770 | |
| (435) 656-2995 | |
| Not Available |
| Full Name | Desert Edge Medical |
|---|---|
| Speciality | Clinic/Center |
| Location | 1664 S Dixie Dr Ste D201, St George, Utah |
| Authorized Official Name and Position | Ryan T Borrowman (OWNER) |
| Authorized Official Contact | 4356562995 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Desert Edge Medical 93 W Orchard Ln Washington UT 84780-2072 Ph: (435) 862-5925 | Desert Edge Medical 1664 S Dixie Dr Ste D201 St George UT 84770 Ph: (435) 656-2995 |
| NPI Number | 1588162911 |
|---|---|
| Provider Enumeration Date | 01/31/2018 |
| Last Update Date | 03/28/2019 |
| Medicare PECOS PAC ID | 2961742051 |
|---|---|
| Medicare Enrollment ID | O20190328000270 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588162911 | NPI | - | NPPES |
| 1487001442 | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | (Utah) | Primary |
| Provider Name | Diana Grazulis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124055710 PECOS PAC ID: 1658275425 Enrollment ID: I20040818000321 |
| Provider Name | Melissa J Hinton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043545536 PECOS PAC ID: 2062557440 Enrollment ID: I20100310000404 |
| Provider Name | Ryan T Borrowman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487001442 PECOS PAC ID: 6608154299 Enrollment ID: I20161102001982 |
| Provider Name | Staycha Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346817061 PECOS PAC ID: 5597165241 Enrollment ID: I20210617000011 |
Pure Life Health And Wellness Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 617 E Riverside Dr Ste 104, St George, UT 84790 Phone: 801-638-7826 | |
Southwest Internal Medicine, P. C. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 736 S 900 E, Suite 104, St George, UT 84790 Phone: 435-628-9200 Fax: 435-674-5763 | |
Concierge Clinic Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1224 S River Rd Ste B101, St George, UT 84790 Phone: 435-236-0835 | |
William T Graff Md Faafp Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 630 S 400 E Ste 101, St George, UT 84770 Phone: 435-673-9653 | |
Amara Health And Wellness Center Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 558 E Riverside Dr, Ste 200, St George, UT 84790 Phone: 435-652-9355 | |
Women's Wellness, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 301 North 200 East, Suite 2c, St George, UT 84770 Phone: 435-674-1700 Fax: 435-674-4681 | |
Nancy L Knape Crna Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1791 E 280 N, St George, UT 84790 Phone: 435-656-2020 Fax: 435-673-4131 |