| Mountain West Family Practice LLC | |
|
2356 N 400 E Suite 201 Tooele UT 84074 | |
| (435) 882-2350 | |
| (435) 882-2039 |
| Full Name | Mountain West Family Practice LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 2356 N 400 E, Tooele, Utah |
| Authorized Official Name and Position | Blake Beazer (PRESIDENT) |
| Authorized Official Contact | 4358822350 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain West Family Practice LLC 2356 N 400 E Suite 201 Tooele UT 84074 Ph: (435) 882-2350 | Mountain West Family Practice LLC 2356 N 400 E Suite 201 Tooele UT 84074 Ph: (435) 882-2350 |
| NPI Number | 1770581605 |
|---|---|
| Provider Enumeration Date | 07/13/2005 |
| Last Update Date | 11/24/2020 |
| Certification Date | 11/24/2020 |
| Medicare PECOS PAC ID | 6406813070 |
|---|---|
| Medicare Enrollment ID | O20041215000392 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770581605 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 2005172 (Utah) | Primary |
| Provider Name | Sergio O Abarca |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245238617 PECOS PAC ID: 2769449339 Enrollment ID: I20041217000125 |
| Provider Name | Blake R Beazer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073510012 PECOS PAC ID: 5395702963 Enrollment ID: I20041217000245 |
| Provider Name | Chad S Jarvis |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1619974664 PECOS PAC ID: 5890745228 Enrollment ID: I20050124001028 |
| Provider Name | Craig a Packham |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1104920354 PECOS PAC ID: 2860559523 Enrollment ID: I20090324000542 |
| Provider Name | Jonathan D Atkin |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1861725889 PECOS PAC ID: 7416094503 Enrollment ID: I20091021000865 |
| Provider Name | Jesse Yarrington |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1013466978 PECOS PAC ID: 8628355484 Enrollment ID: I20170503001481 |
| Provider Name | Dale James Bingham |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1376547935 PECOS PAC ID: 5597662130 Enrollment ID: I20171207000986 |
| Provider Name | Cameron Cooper |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1518453976 PECOS PAC ID: 0648524652 Enrollment ID: I20181109002098 |
| Provider Name | Amanda L Sheffer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720632078 PECOS PAC ID: 6103154216 Enrollment ID: I20190828001405 |
| Provider Name | Brooke Ludwig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134750110 PECOS PAC ID: 6103257639 Enrollment ID: I20200515001914 |
| Provider Name | Dana Michelle Pickle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265050660 PECOS PAC ID: 9436573722 Enrollment ID: I20200720002167 |
| Provider Name | Lori C Hamilton |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1912338872 PECOS PAC ID: 8426289380 Enrollment ID: I20200722001810 |
| Provider Name | Justin M Cox |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1184293813 PECOS PAC ID: 3971905308 Enrollment ID: I20210708000618 |
Valley Family Medicine PC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2376 N 400 E Ste 102, Tooele, UT 84074 Phone: 435-843-1225 Fax: 435-843-1228 |
Oasis Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1929 Aaron Dr, Suite I, Tooele, UT 84074 Phone: 435-833-0229 Fax: 435-833-0231 |
Spine and Posture Rehabilitation of Tooele Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 300 S Main St, Suite 2, Tooele, UT 84074 Phone: 435-882-1621 Fax: 435-882-8267 |
Tooele Clinic Corp Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1887 Aaron Dr Ste B, Tooele, UT 84074 Phone: 435-775-9973 Fax: 435-775-9985 |
Granger Medical Clinic PC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2356 N 400 E Ste 201, Tooele, UT 84074 Phone: 801-352-5900 Fax: 801-352-5914 |
Ram C Sharma, MD PC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 255 S 100 E, Tooele, UT 84074 Phone: 435-882-0424 Fax: 435-843-1511 |