Mary C Freesh, DO

Individual provider Active NPI Family Medicine Physician · Ivins, UT

NPI 1700031473 · NPPES record last updated Nov 22, 2008

Key facts

NPI
1700031473
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
1730821204 (UT)
Practice address
272 E Center St
Suite 201
Ivins, UT 84738-6456
Phone
(435) 986-2300
NPI assigned
Nov 22, 2008
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
1730821204UTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rocky Vista Health Center LLC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8078/brand/1/csg/1/fhir/r4

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1730821204 UT Yes

Addresses

Primary practice location

272 E Center St
Suite 201
Ivins, UT 84738-6456

Mailing address

272 E Center St
Suite 201
Ivins, UT 84738-6456
Phone (435) 986-2300

Other names

  • Mary F Jones Other name

Other providers in Ivins, UT

All providers in Ivins, UT · Family Medicine Physician in Utah

Sources for this page

Verify at the official NPI Registry.