DR. LARRY T WILCKEN (NPI# 1790817013) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790817013 |
| Entity Type | Individual |
| Full Name | DR. LARRY T WILCKEN |
| Credential | MD |
| Practice Address |
151 W 200 N Vernal UT 84078-1907 |
| Mailing Address |
3618 Dry Fork Canyon Rd Vernal UT 84078-9404 |
| Practice Telephone | 4357893342 |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2010-03-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 158064-1205 | UT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | H1232 | 05 | |
| UT | 05135 | 05 |
| Street Address |
151 W 200 N |
| City | VERNAL |
| State | UT |
| Zip Code | 84078-1907 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174573679 | Hilary J. Sarhatt | Family Medicine | 151 W 200 N, Vernal, UT 84078-1907 | 2006-05-12 |
| 1104055821 | Brett Wallace Bulloch | Nurse Anesthetist, Certified Registered | 151 W 200 N, Vernal, UT 84078-1908 | 2009-07-02 |
| 1174783492 | Shane Verl Theobald | Nurse Anesthetist, Certified Registered | 151 W 200 N, Vernal, UT 84078-1907 | 2008-06-10 |
| 1063629830 | Dean G Anderson | Emergency Medicine | 151 W 200 N, Ashley Regional Medical Center, Vernal, UT 84078-1907 | 2007-05-17 |
| 1285753541 | Basin Anesthesia Associates, Inc. | Nurse Anesthetist, Certified Registered | 151 W 200 N, Vernal, UT 84078-1907 | 2007-03-28 |
| 1417075102 | Michael Arthur Hartman | Nurse Anesthetist, Certified Registered | 151 W 200 N, Vernal, UT 84078-1907 | 2007-03-27 |
| 1700904455 | Dee Lewis Bambrough | Nurse Anesthetist, Certified Registered | 151 W 200 N, Vernal, UT 84078-1907 | 2007-03-27 |
| 1659409159 | David Andrew Bestenelhner | Pharmacist | 151 W 200 N, Vernal, UT 84078-1907 | 2007-02-28 |
| 1962530477 | Ben Dogan Semadeni | Pharmacist | 151 W 200 N, Vernal, UT 84078-1907 | 2007-02-28 |
| 1568563591 | Bruce A Daniel | Emergency Medicine | 151 W 200 N, Vernal, UT 84078-1907 | 2006-09-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205479748 | Wade Oliver Moulton | Pharmacist | 1080 W Hwy 40, Vernal, UT 84078 | 2019-10-28 |
| 1841610383 | Allegiance Addiction Recovery Center | Substance Abuse Rehabilitation Facility | 4430 N Little Valley Road, Vernal, UT 84078 | 2014-04-23 |
| 1689008773 | Ashley Valley Physician Practice, LLC | Occupational Therapist | 1680 W Highway 40 Ste 202, Vernal, UT 84078 | 2013-08-26 |
| 1528371796 | Terry L Smith | Counselor | 1140 W 500 S #9, Vernal, UT 84078 | 2010-07-16 |
| 1619280880 | Cicile M Rios | Counselor | 1140 W 800 S #9, Vernal, UT 84078 | 2010-07-16 |
| 1265754840 | Marjorie Elaine Gardner | Licensed Practical Nurse | 133 S 500 East, Vernal, UT 84078 | 2010-02-23 |
| 1528205853 | Robert Kirkham Jolley | Dentist | 40 West 100 North, Vernal, UT 84078 | 2009-01-08 |
| 1740482025 | Ashley Valley Physician Practice, LLC | Family Medicine | 175 N. 100 W., Suite 202, Vernal, UT 84078 | 2007-05-31 |
| 1265646459 | Ashley Valley Medical Center | Pharmacy | 151 W. 200 N., Vernal, UT 84078 | 2007-05-09 |
| 1629122692 | Brian Prentice Callahan | Dentist | 779 West Us Highway 40, Vernal, UT 84078 | 2007-01-23 |
| Find all providers in zip 84078 | ||||
| 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 |
|---|---|---|---|---|
| 1801226907 | Mountainlands Community Health Center Inc | Family Medicine | 1680 W Highway 40, Suite 201, Vernal, UT 84078-4135 | 2013-11-26 |
| 1740482025 | Ashley Valley Physician Practice, LLC | Family Medicine | 175 N. 100 W., Suite 202, Vernal, UT 84078 | 2007-05-31 |
| 1598984544 | Melvin Ray | Family Medicine | 379 N 500 W, Suite 1a, Vernal, UT 84078-1956 | 2007-04-25 |
| 1881779809 | Ashley Valley Family Practice | Family Medicine | 872 W Highway 40, Vernal, UT 84078-2416 | 2006-10-26 |
| 1396838918 | Basin Medical Clinic LLC | Family Medicine | 379 North 500 West, Suite 1a, Vernal, UT 84078 | 2006-10-02 |
| 1174573679 | Hilary J. Sarhatt | Family Medicine | 151 W 200 N, Vernal, UT 84078-1907 | 2006-05-12 |
| 1407143324 | Matthew C Bowen | Family Medicine | 175 N 100 W, Suite 205a, Vernal, UT 84078-2049 | 2011-06-29 |
| 1588973978 | Alma Parker Md PC | Family Medicine | 175 N 100 W, Ste 205c, Vernal, UT 84078-2049 | 2010-10-01 |
| 1891941662 | Melanie Ann Hardy | Family Medicine | 150 W 100 N, Vernal, UT 84078-2036 | 2008-08-13 |
| 1891914941 | Dallon Whitney | Family Medicine | 379 N 500 W, Suite 1a, Vernal, UT 84078-1956 | 2007-04-25 |
| Find all providers in VERNAL | ||||
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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.