Timothy A Dennis, PA-C
Individual provider Active NPI Physician Assistant · Panguitch, UT
NPI 1376541102 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1376541102
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 104445-1206 (UT)
- Practice address
- 224 N. 400 East
Panguitch, UT 84759 - Phone
- (435) 676-8842
- Fax
- (435) 676-2679
- NPI assigned
- Jul 14, 2005
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 104445-1206 | UT | MD | Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 104445-1206 | UT | Yes |
Addresses
Primary practice location
224 N. 400 East
Panguitch, UT 84759
Mailing address
PO Box 1096
Panguitch, UT 84759
Phone (435) 676-8758
Other providers in Panguitch, UT
- Sherrie Burningham
- Carl Van Gils, DPM, PC
- Deborah Coles
- Joseph Coombs
- Maxi Edra Dax
- Theron A Draper
- Eric C Fawson
- Frandsen & Albrecht Physical Therapy Inc
- David Bert Frandsen
- Jan P Frandsen
All providers in Panguitch, UT · Physician Assistant in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.