Dr Clark John Staheli, MD in Dammeron Valley, UT - Medicare Family Medicine

Dr Clark John Staheli, MD is a medicare enrolled "Family Medicine" physician in Dammeron Valley, Utah. His current practice location is 8555 North Highway 18, Dammeron Valley, Utah. You can reach out to his office (for appointments etc.) via phone at (435) 574-2546.

Dr Clark John Staheli is licensed to practice in Utah (license number 148105-1205) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1568505691.

Contact Information

	Dr Clark John Staheli, MD
	8555 North Highway 18, Dammeron Valley, UT 84783
	(435) 574-2546
	(435) 574-2619

Physician's Profile

Full Name	Dr Clark John Staheli
Gender	Male
Speciality	Family Medicine
Location	8555 North Highway 18, Dammeron Valley, Utah
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1568505691
Provider Enumeration Date: 02/15/2007
Last Update Date: 03/22/2011

Medicare PECOS Information:

PECOS PAC ID: 7517918238
Enrollment ID: I20060107000022

Medical Identifiers

Medical identifiers for Dr Clark John Staheli such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1568505691	NPI	-	NPPES
03698	Medicaid	UT

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	1481051205 (Utah)	Secondary
207Q00000X	Family Medicine	148105-1205 (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. Dr Clark John Staheli is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Clark John Staheli, MD 8555 North Highway 18, Dammeron Valley, UT 84783 Ph: (801) 429-8000	Dr Clark John Staheli, MD 8555 North Highway 18, Dammeron Valley, UT 84783 Ph: (435) 574-2546

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Dr Clark John Staheli, MD - Medicare Family Medicine in Dammeron Valley, UT