Mckennan Thurston (NPI# 1194088856, PAC ID# 6507002573) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1194088856 |
| PAC ID by PECOS | 6507002573 |
| Professional Enrollment ID | I20160624001733 |
| Full Name | Mckennan Thurston |
| Organization Legal Name | TANNER MEMORIAL CLINIC |
| Address |
1750 E 3100 Layton UT 84040-2406 |
| Phone Number | 8017734840 |
| Gender | M |
| Graduation Year | 2012 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 4284547985 |
| Number of Group Practice Members | 144 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 460041 | DAVIS HOSPITAL AND MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1750 E 3100, Layton, UT 84040-2406 | 8017734840 | TANNER MEMORIAL CLINIC |
| 3443 W 5600, Roy, UT 84067-9112 | 8017734840 | TANNER MEMORIAL CLINIC |
| Organization Legal Name | TANNER MEMORIAL CLINIC |
| Physicians | 150 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Aaron Joseph Reich | Physician Assistant | Tanner Memorial Clinic | 2121 N 1700, Tanner Clinic, Layton, UT 84041-8803 |
| Brett M Rawlins | Nurse Practitioner | Tanner Memorial Clinic | 1477 N 2000, Suite C, Clinton, UT 84015-9099 |
| Tyler R Williams | Internal Medicine | Tanner Memorial Clinic | 3443 W 5600, Roy, UT 84067-9112 |
| Loida M Viera Hutchins | Internal Medicine | Tanner Memorial Clinic | 5296 S Commerce Dr, Suite 104, Murray, UT 84107-5363 |
| Dustin Gary Child | Family Medicine | Tanner Memorial Clinic | 380 N 400, Tanner Clinic, Kaysville, UT 84037-3135 |
| Warren L Butler | Family Medicine | Tanner Memorial Clinic | 2038 W 1900, Tanner Clinic, Syracuse, UT 84075-9320 |
| Khaldoun M Al Rayess | Internal Medicine | Tanner Memorial Clinic | 2121 N 1700, Tanner Clinic, Layton, UT 84041-8803 |
| Brian W Pugh | Gastroenterology | Tanner Memorial Clinic | 2121 N 1700, Tanner Clinic, Layton, UT 84041-8803 |
| Robert L Mellor | Otolaryngology | Tanner Memorial Clinic | 2121 N 1700, Tanner Clinic, Layton, UT 84041-8803 |
| Nicole Stapley | Nurse Practitioner | Tanner Memorial Clinic | 380 N 400, Tanner Clinic, Kaysville, UT 84037-3135 |
| Street Address |
1750 E 3100 |
| City | LAYTON |
| State | UT |
| Zip | 84040-2406 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kenneth W Jee | Orthopedic Surgery | Tanner Memorial Clinic | 1750 E 3100, Layton, UT 84040-2406 |
| Lisa A Harward | Nurse Practitioner | Tanner Memorial Clinic | 1750 E 3100, Layton, UT 84040-2406 |
| Chase E Mitchell | Nurse Practitioner | Tanner Memorial Clinic | 1750 E 3100, Layton, UT 84040-2406 |
| Cassie L Whittier | Family Medicine | Tanner Memorial Clinic | 1750 E 3100, Layton, UT 84040-2406 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ryan C Jeffery | Chiropractic | 1037 Kimberly Dr, Layton, UT 84040-2805 | |
| Brandon Robb | Chiropractic | 116 N Adamswood Rd, Suite 1, Layton, UT 84040-4004 | |
| Joseph V Bowden | Chiropractic | 116 N Adamswood Rd, Layton, UT 84040-4004 | |
| Casey Lawrence Stelter | Family Medicine | Layton Family Practice LLC | 2950 N Church St, Suite 200, Layton, UT 84040-6504 |
| Jonathan A Weeks | Family Medicine | Layton Family Practice LLC | 2950 N Church St, Suite 200, Layton, UT 84040-6504 |
| Jody L Fowers | Nurse Practitioner | Layton Family Practice LLC | 2950 N Church St, Suite 200, Layton, UT 84040-6504 |
| David H Warby | Podiatry | David H Warby Dpm | 2950 N Church St, Suite 303, Layton, UT 84040-6590 |
| City | LAYTON |
| Zip Code | 84040 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | LAYTON + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Mckennan Thurston.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.