| Regenerative Medicine Of Utah, Llc | |
|
2297 N Hill Field Rd Ste 101 Layton UT 84041-6927 | |
| (801) 776-3200 | |
| Not Available |
| Full Name | Regenerative Medicine Of Utah, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2297 N Hill Field Rd Ste 101, Layton, Utah |
| Authorized Official Name and Position | Darren Scott (OWNER, AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 8017763200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Regenerative Medicine Of Utah, Llc 2297 N Hill Field Rd Ste 101 Layton UT 84041-6927 Ph: (801) 776-3200 | Regenerative Medicine Of Utah, Llc 2297 N Hill Field Rd Ste 101 Layton UT 84041-6927 Ph: (801) 776-3200 |
| NPI Number | 1417595497 |
|---|---|
| Provider Enumeration Date | 12/20/2019 |
| Last Update Date | 12/20/2019 |
| Medicare PECOS PAC ID | 6305273871 |
|---|---|
| Medicare Enrollment ID | O20200221001406 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417595497 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Marilyn B Wise |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720098189 PECOS PAC ID: 5698877066 Enrollment ID: I20070305000062 |
| Provider Name | Angela Gerrard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770967200 PECOS PAC ID: 9436467248 Enrollment ID: I20150928002795 |
| Provider Name | Dana Shelton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811409774 PECOS PAC ID: 3971851692 Enrollment ID: I20180811000338 |
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