| San Juan Health Services District | |
|
380 West 100 North Monticello UT 84535-0308 | |
| (435) 587-2116 | |
| (435) 587-2061 |
| Full Name | San Juan Health Services District |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 380 West 100 North, Monticello, Utah |
| Authorized Official Name and Position | Clayton H. Holt (CEO) |
| Authorized Official Contact | 4355872116 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| San Juan Health Services District Po Box 308 380 W 100 N Monticello UT 84535-0308 Ph: (435) 587-2116 | San Juan Health Services District 380 West 100 North Monticello UT 84535-0308 Ph: (435) 587-2116 |
| NPI Number | 1942251459 |
|---|---|
| Provider Enumeration Date | 05/12/2006 |
| Last Update Date | 01/19/2016 |
| Medicare PECOS PAC ID | 4486541851 |
|---|---|
| Medicare Enrollment ID | O20060905000582 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942251459 | NPI | - | NPPES |
| Provider Name | Marc F Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962572487 PECOS PAC ID: 5890881759 Enrollment ID: I20080916000022 |
| Provider Name | Edwin M Wyman |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1730171620 PECOS PAC ID: 8628966512 Enrollment ID: I20100503000779 |
| Provider Name | Matthew H Lyman |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1851307706 PECOS PAC ID: 4688747736 Enrollment ID: I20100916001218 |
| Provider Name | Kelly Jeppesen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568790558 PECOS PAC ID: 6608060876 Enrollment ID: I20101101001549 |
| Provider Name | James Walker |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1194021014 PECOS PAC ID: 1557546348 Enrollment ID: I20110420000565 |
| Provider Name | Douglas Zeb Crofts |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588924658 PECOS PAC ID: 8224351200 Enrollment ID: I20150910000176 |
| Provider Name | Michael Nielson |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1700225679 PECOS PAC ID: 2264735455 Enrollment ID: I20160622000080 |
| Provider Name | Jane Sparks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285043885 PECOS PAC ID: 1254636939 Enrollment ID: I20161130002094 |
| Provider Name | Mario D La Giglia |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1013145697 PECOS PAC ID: 2860782927 Enrollment ID: I20180412001498 |
| Provider Name | Alana Klase-freeman |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1740436518 PECOS PAC ID: 6709175631 Enrollment ID: I20190612002843 |
| Provider Name | Jason D Doel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811424815 PECOS PAC ID: 0143573782 Enrollment ID: I20200731001679 |
Imed Utah Heart - Monticello Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 380 W 100 N, Monticello, UT 84535 Phone: 801-507-3500 | |
San Juan Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 380 W 100 N, Suite A, Monticello, UT 84535 Phone: 435-587-5054 Fax: 435-587-3004 |