| Sandy Family Practice | |
|
8706 S 700 E Ste 203 Sandy UT 84070-1809 | |
| (801) 572-0443 | |
| (801) 571-1987 |
| Full Name | Sandy Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 8706 S 700 E Ste 203, Sandy, Utah |
| Authorized Official Name and Position | Douglas Malcolm Vogeler (PRESIDENT) |
| Authorized Official Contact | 8015720443 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sandy Family Practice 8706 S 700 E Ste 203 Sandy UT 84070-1809 Ph: (801) 572-0443 | Sandy Family Practice 8706 S 700 E Ste 203 Sandy UT 84070-1809 Ph: (801) 572-0443 |
| NPI Number | 1811555642 |
|---|---|
| Provider Enumeration Date | 06/05/2019 |
| Last Update Date | 06/10/2019 |
| Medicare PECOS PAC ID | 0345576336 |
|---|---|
| Medicare Enrollment ID | O20190729003736 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811555642 | NPI | - | NPPES |
| 1902154172 | Other | UT | FAMILY PRACTICE |
| 1790869550 | Other | UT | FAMILY PRACTICE |
| 1811555642 | Other | UT | FAMILY PRACTICE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Douglas M Vogeler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790869550 PECOS PAC ID: 1850466566 Enrollment ID: I20080814000585 |
| Provider Name | John Michael Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902154172 PECOS PAC ID: 9638498975 Enrollment ID: I20160920002072 |
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