| Thyroid Clinic Llc | |
|
1055 N 300 W Ste 315 Provo UT 84604-3373 | |
| (385) 205-6510 | |
| (385) 375-6112 |
| Full Name | Thyroid Clinic Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1055 N 300 W Ste 315, Provo, Utah |
| Authorized Official Name and Position | Laura John (CREDENTIALING) |
| Authorized Official Contact | 8012316986 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thyroid Clinic Llc 4465 S 900 E Ste 200 Salt Lake City UT 84124-2695 Ph: (385) 205-6510 | Thyroid Clinic Llc 1055 N 300 W Ste 315 Provo UT 84604-3373 Ph: (385) 205-6510 |
| NPI Number | 1003493933 |
|---|---|
| Provider Enumeration Date | 03/26/2021 |
| Last Update Date | 01/25/2022 |
| Medicare PECOS PAC ID | 1951796770 |
|---|---|
| Medicare Enrollment ID | O20220315000270 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003493933 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
| Provider Name | Ian J Orozco |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1477688307 PECOS PAC ID: 8820180359 Enrollment ID: I20220315000389 |
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