MARK W UDY (NPI# 1659405314) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659405314 |
| Entity Type | Individual |
| Full Name | MARK W UDY |
| Credential | PA-C |
| Practice Address |
1490 E Foremaster Dr Ste 220 St George UT 84790-4498 |
| Mailing Address |
1490 E Foremaster Dr Ste 220 St George UT 84790-4488 |
| Practice Telephone | 4352167000 |
| Practice Fax Number | 4352167001 |
| Mailing Telephone | 4352167000 |
| Mailing Fax Number | 4352167001 |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2015-04-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
6781192-1206 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
PA-425 | ID | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1490 E FOREMASTER DR STE 220 |
| City | ST GEORGE |
| State | UT |
| Zip Code | 84790-4498 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235762295 | Rebecca Ann Garner | Nurse Practitioner | 1490 E Foremaster Dr Ste 220, St George, UT 84790-4498 | 2020-02-18 |
| 1790187904 | Brian Jorgensen | Physician Assistant | 1490 E Foremaster Dr Ste 220, St George, UT 84790-4498 | 2014-09-18 |
| 1376839902 | Coral Desert Spine Surgery | Specialist | 1490 E Foremaster Dr Ste 220, St George, UT 84790-4498 | 2011-06-22 |
| 1437383932 | Bart Tiberius Hunter | Nurse Practitioner | 1490 E Foremaster Dr Ste 220, St George, UT 84790-4498 | 2009-05-12 |
| 1477724516 | Gary Don Snook Md PC | Specialist | 1490 E Foremaster Dr Ste 220, St George, UT 84790-4498 | 2008-03-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396342713 | Katrina Poulsen | Student in an Organized Health Care Education/Training Program | 617 East Rriverside Dr, Ste 301, St. George, UT 84790 | 2020-10-08 |
| 1124643226 | Desert View Eyecare | Optometrist | 15 South River Road St. 150, St. George, UT 84790 | 2020-06-15 |
| 1366066417 | Benjamin Todd Lloyd | Dentist | 1683 E. Wolf Hole Dr, St. George, UT 84790 | 2020-06-04 |
| 1801434584 | Jennifer M Putnam | Marriage & Family Therapist | 321 North Mall Drive, Vw103, St. George, UT 84790 | 2019-12-12 |
| 1326683012 | Red Mountain Counseling and Education | Counselor | 321 No Mall Dr, Vw 103, St. George, UT 84790 | 2019-11-17 |
| 1295376002 | Karynne Kimberly Simpson | Behavior Technician | 280 N 1680 E U1, St. George, UT 84790 | 2019-10-02 |
| 1962053017 | Mikala Larsen | Nurse Practitioner | 1380 S Medical Center Dr., Saint George, UT 84790 | 2019-09-20 |
| 1326690678 | Joe Ballent | Student in an Organized Health Care Education/Training Program | 1526 S Medical Center Dr Ste 224a, St George, UT 84790 | 2019-07-16 |
| 1558923854 | David Pace | Optometrist | 749 South River Rd, St. George, UT 84790 | 2019-07-08 |
| 1639734924 | Mariah Ann Mertlich | Behavioral Analyst | 280 N 1680 E, U1, St. George, UT 84790 | 2019-05-02 |
| Find all providers in zip 84790 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710416649 | Brian Adams | Physician Assistant | 1308 E 900 S # C, St George, UT 84790-8520 | 2017-06-05 |
| 1144403114 | Gay Sleight | Physician Assistant | 558 E Riverside Dr Suite 200, St George, UT 84790 | 2007-12-12 |
| 1255788303 | Elijah Adam Fielding | Physician Assistant | 25 N 100 E Ste 102, St George, UT 84770-7369 | 2016-05-18 |
| 1457610255 | Bonnie Lynn Wood | Physician Assistant | 1036 E Riverside Dr, St George, UT 84790-4477 | 2012-05-14 |
| 1053677245 | Richard C Tebbs II | Physician Assistant | 544 S 400 E, St George, UT 84770-3705 | 2012-04-02 |
| 1407159130 | Brian Dwayne Lefler | Physician Assistant | 301 N 200 E Ste 2a, St George, UT 84770-3040 | 2010-12-20 |
| 1386876761 | Ethan Lowell Snyder | Physician Assistant | 368 E Riverside Dr, Suite A, St George, UT 84790-6896 | 2009-08-18 |
| 1306063912 | Holly Marie Ferguson | Physician Assistant | 544 S 400 E, St George, UT 84770-3705 | 2007-04-18 |
| 1285735688 | Cortney A Bernardo | Physician Assistant | 1490 E Foremaster Dr, Ste 220, St George, UT 84790-4488 | 2006-09-26 |
| 1508962309 | Lee S Hogan | Physician Assistant | 1067 E Tabernacle St, Ste 7, St George, UT 84770-3163 | 2006-09-16 |
| Find all providers in ST GEORGE | ||||
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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.