FORT DUCHESNE INDIAN HEALTH CENTER RADIOLOGY (NPI# 1306076625) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306076625 |
| Entity Type | Organization |
| Organization Name | FORT DUCHESNE INDIAN HEALTH CENTER RADIOLOGY |
| Other Organization Name | FORT DUCHESNE INDIAN HEALTH CENTER RADIOLOGY |
| Practice Address |
6822 East 1000 South Fort Duchesne UT 84026 |
| Practice Telephone | 4357256874 |
| Practice Fax Number | 4357256889 |
| Mailing Telephone | 4357256874 |
| Mailing Fax Number | 4357256889 |
| Enumeration Date | 2009-07-21 |
| Last Update Date | 2013-04-04 |
| Authorized Official Name | MR. DELBERT GARY MARTIN (CHIEF PHARMACIST) |
| Authorized Official Telephone | 4357256874 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0200X |
Clinic/Center Specialization: Radiology |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | 700000000009 | 05 |
| Other Name | Type Code |
|---|---|
| FORT DUCHESNE INDIAN HEALTH CENTER RADIOLOGY | Doing Business As Name - Organization |
| Street Address |
6822 EAST 1000 SOUTH |
| City | FORT DUCHESNE |
| State | UT |
| Zip Code | 84026 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053319525 | Lawrence Michael Zubel | Optometrist | 6822 East 1000 South, Fort Duchesne, UT 84026 | 2005-07-08 |
| 1003275777 | Chantelle Remenak | Registered Nurse | 6822 East 1000 South, Fort Duchesne, UT 84026-0160 | 2016-02-23 |
| 1518244086 | Dhhs Ihs Phoenix Area | Clinic/Center | 6822 East 1000 South, Fort Duchesne, UT 84026 | 2011-11-10 |
| 1336379650 | Fort Duchesne Indian Health Center Laboratory | Clinical Medical Laboratory | 6822 East 1000 South, Fort Duchesne, UT 84026 | 2009-07-21 |
| 1508040015 | Willis Manford Gooch IIi | Pediatrics | 6822 East 1000 South, Fort Duchesne, UT 84026 | 2007-12-19 |
| 1982814471 | Frank Britton Martin | Pharmacist | 6822 East 1000 South, Fort Duchesne, UT 84026 | 2007-05-23 |
| 1063629426 | James Kevin Farrell | Pharmacist | 6822 East 1000 South, Fort Duchesne, UT 84026 | 2007-05-16 |
| 1205051950 | Juanita M Fox | Registered Nurse | 6822 East 1000 South, Fort Duchesne, UT 84026-0160 | 2007-04-16 |
| 1881724417 | Craig Blackham | Dentist | 6822 East 1000 South, Fort Duchesne, UT 84026 | 2007-03-06 |
| 1316097785 | Dhew Ind Hlth Sv Hlth Svs & Mntal Hlth Adm | Durable Medical Equipment & Medical Supplies | 6822 East 1000 South, Ft Duchesne Indian Health Center Dme, Fort Duchesne, UT 84026 | 2007-01-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568024347 | Jake Richardson | Dentist | 6932 E 1400 S, Fort Duchesne, UT 84026 | 2019-07-02 |
| 1740736321 | Infinite Quality Care | Assisted Living Facility | 338 W 2600 N, Pleasant Grove, UT 84026 | 2016-09-01 |
| 1225401763 | Ute Tribe Alcohol/substance Abuse Prevention | Community/Behavioral Health | 550 South 6777 East, Fort Duchesne, UT 84026 | 2015-11-05 |
| 1225400534 | Paul Jones | Licensed Practical Nurse | 6822 East / 1000 South, Fort Duchesne, UT 84026 | 2015-10-26 |
| 1932360054 | Dhew Ind Hlth Sv Hlth Svs & Mntl Hlth Adm | Dentist | 6822 E 1000 South, Fort Duchesne, UT 84026 | 2008-06-20 |
| 1821103094 | Bruce Allen Daniel | Dentist | 6822 E 1000 S, Ft. Duchesne, UT 84026 | 2006-08-20 |
| 1922031533 | Ute Indian Tribe | Ambulance | East Highway 40, Ft Duschesne, UT 84026 | 2006-07-08 |
| 1245842962 | Eve O'pray-nichols | Registered Nurse | 6932 E 1400 S, Ft. Duchesne, UT 84026 | 2020-08-24 |
| 1124644430 | Red Pine Rtc | Substance Abuse Rehabilitation Facility | 550 South 6777 East, Fort Duchesne, UT 84026 | 2020-06-23 |
| 1952955478 | Kadee Pitt | Dental Hygienist | 6932 E 1400 S, Ft. Duchesne, UT 84026 | 2019-08-01 |
| Find all providers in zip 84026 | ||||
| Taxonomy Code | 261QR0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376144758 | Us Sports Medicine, LLC | Clinic/Center | 729 King St Ste 100, Layton, UT 84041-4681 | 2020-11-03 |
| 1720588080 | Us Sports Medicine, LLC | Clinic/Center | 1982 W. Pleasant Grove Blvd, Suite L, Pleasant Grove, UT 84062 | 2018-02-13 |
| 1477086973 | Us Sports Medicine, LLC | Clinic/Center | 6030 Fashion Point Dr, South Ogden, UT 84403-4851 | 2017-04-11 |
| 1386026052 | Western Neurological Group | Clinic/Center | 10169 S 1160 W, South Jordan, UT 84095-8829 | 2015-06-18 |
| 1558314146 | Ihc Health Services, Inc | Clinic/Center | 674 S Highway 99, Fillmore, UT 84631-5013 | 2006-05-18 |
| 1891248936 | Sacred Circle Healthcare | Clinic/Center | 660 S 200 E, Ste 250, Salt Lake City, UT 84111-3835 | 2016-07-25 |
| 1699004499 | Tooele Valley Imaging, LLC | Clinic/Center | 2356 N 400 E, Suite 103, Tooele, UT 84074-3409 | 2009-12-08 |
| 1679758296 | Avocet Medical Imaging Inc | Clinic/Center | 1930 S Highway 89, Perry, UT 84302-4119 | 2008-01-02 |
| 1174642102 | Central Utah Clinic, P.C. | Clinic/Center | 1490 E Foremaster Dr Bldg C, St George, UT 84790-4550 | 2007-03-29 |
| 1588732309 | Cedar Orthopaedic Bone Densitometry | Clinic/Center | 1335 Northfield Rd, Suite 100, Cedar City, UT 84720-9390 | 2006-12-01 |
| Find all providers with the same taxonomy | ||||
| City | FORT DUCHESNE |
| Zip Code | 84026 |
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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.