Corey L Ericksen, DO in Fruit Heights, UT - Family Medicine

Corey L Ericksen, DO is a Family Medicine physician based in Fruit Heights, Utah. Corey L Ericksen is licensed to practice in Utah (license number 171802-1204) and his current practice location is 1762 Viewcourt, Fruit Heights, Utah. He can be reached at his office (for appointments etc.) via phone at (801) 628-8877.

NPI number for Corey L Ericksen is 1912003922 and his current mailing address is 1762 View Ct, Fruit Heights, Utah. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1912003922.

Contact Information

	Corey L Ericksen, DO
	1762 Viewcourt, Fruit Heights, UT 84037
	(801) 628-8877
	Not Available

Physician's Profile

Full Name	Corey L Ericksen
Gender	Male
Speciality	Family Medicine
Location	1762 Viewcourt, Fruit Heights, Utah
Accepts Medicare Assignments	Does not participate in Medicare Program. He may not accept medicare assignment.

NPI Data:

NPI Number: 1912003922
Provider Enumeration Date: 09/16/2006
Last Update Date: 10/21/2019

Medical Identifiers

Medical identifiers for Corey L Ericksen such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1912003922	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	171802-1204 (Utah)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Corey L Ericksen is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Corey L Ericksen, DO 1762 View Ct, Fruit Heights, UT 84037-6704 Ph: (801) 628-8877	Corey L Ericksen, DO 1762 Viewcourt, Fruit Heights, UT 84037 Ph: (801) 628-8877

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Corey L Ericksen, DO - Family Medicine in Fruit Heights, UT