GLENN O MORTENSEN (NPI# 1184634669) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184634669 |
| Entity Type | Individual |
| Full Name | GLENN O MORTENSEN |
| Credential | MD |
| Practice Address |
1750 N 1000 E Logan UT 84341-1909 |
| Practice Telephone | 4357571516 |
| Mailing Telephone | 4357571516 |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2016-02-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 1609171205 | UT | Allopathic & Osteopathic Physicians |
| Street Address |
1750 N 1000 E |
| City | LOGAN |
| State | UT |
| Zip Code | 84341-1909 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538701529 | Aubrey Salmond | Registered Nurse | 500 East 1500 N, Logan, UT 84341 | 2019-10-11 |
| 1043702046 | Eye Pros of Logan LLC | Optometrist | 1475 N Main St Ste 103, Logan, UT 84341 | 2018-06-05 |
| 1275050452 | Rylie Jeanne Cook | Student in an Organized Health Care Education/Training Program | 11 Aggie Village Apt. J, Logan, UT 84341 | 2017-08-28 |
| 1093262156 | Jessica Lynn Mcgarry | Social Worker | 1040 N 130 W, Apt 100, Logan, UT 84341 | 2016-09-07 |
| 1740663566 | Paul R Gregory | Occupational Therapy Assistant | 1300 N 500 E Suite 120, Suite 120, Logan, UT 84341 | 2015-06-30 |
| 1851708846 | Bradley Budge | Optometrist | 535 E 1400 N Ste 130, Logan, UT 84341 | 2014-07-22 |
| 1386058709 | Daniel Raymond Carlson | Physician Assistant | 500 E. 1400 N., Logan, UT 84341 | 2014-06-13 |
| 1902220239 | Work Injury Solutions Inc. | Clinic/Center | 630 E 1400 N Ste 140, Logan, UT 84341 | 2014-02-06 |
| 1750627287 | Lee Martin Williams Sr. | Counselor | 186 E. 1800 N., North Logan, UT 84341 | 2013-01-03 |
| 1669747804 | Ronald J Payne | Internal Medicine | 1726 North 1850 East, North Logan, UT 84341 | 2012-03-21 |
| Find all providers in zip 84341 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881762649 | Bruce A Isaacson | Family Medicine | 550 E 1400 N Ste Z, Logan, UT 84341-2407 | 2006-12-01 |
| 1295744522 | Michael C Housley | Family Medicine | 500 E 1400 N, Logan, UT 84341-2465 | 2006-08-05 |
| 1477562767 | Ronald Mark Firth | Family Medicine | 1015 E. 100 N., Logan, UT 84321 | 2006-08-05 |
| 1093723835 | David N N Casey | Family Medicine | 412 N. 200 E., Logan, UT 84321 | 2006-08-04 |
| 1104830884 | Nathan H Call | Family Medicine | 1652 S Main St, Logan, UT 84321-8504 | 2006-07-28 |
| 1033156849 | Brant Wahlen Fonnesbeck | Family Medicine | 550 E 1400 N Ste K, Logan, UT 84341-2450 | 2006-06-01 |
| 1821049776 | Eden Family Practice Inc. | Family Medicine | 313 Hudgins St, Suite 200, Logan, WV 25601-3535 | 2006-05-15 |
| 1114981024 | Ernesto Manuel | Family Medicine | 396 Dingess St, Logan, WV 25601-3624 | 2006-04-17 |
| 1295724359 | David L Cummin | Family Medicine | 751 State Route 664 N, Logan, OH 43138-9250 | 2005-10-20 |
| 1235133091 | James R Hayward | Family Medicine | 819 State Route 664 N, Ste A, Logan, OH 43138-8540 | 2005-06-09 |
| Find all providers in LOGAN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.