Kazan Ivan W Memorial Clinic - Medicare Primary Care in Escalante, UT

Kazan Ivan W Memorial Clinic is a medicare enrolled primary clinic (Clinic/center - Federally Qualified Health Center (fqhc)) in Escalante, Utah. The current practice location for Kazan Ivan W Memorial Clinic is 570 E Moqui Ln, Escalante, Utah. For appointments, you can reach them via phone at (435) 826-4374. The mailing address for Kazan Ivan W Memorial Clinic is Po Box 303, Bicknell, Utah and phone number is (435) 425-3744.

Kazan Ivan W Memorial Clinic is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1568886000. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (435) 826-4374.

Contact Information

Kazan Ivan W Memorial Clinic
570 E Moqui Ln
Escalante
UT 84726-0276
(435) 826-4374
Not Available

Primary Care Clinic Profile

Full NameKazan Ivan W Memorial Clinic
SpecialityClinic/Center
Location570 E Moqui Ln, Escalante, Utah
Authorized Official Name and PositionEvan Christensen (EXECUTIVE DIRECTOR)
Authorized Official Contact4354253744
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Kazan Ivan W Memorial Clinic
Po Box 303
Bicknell
UT 84715-0303

Ph: (435) 425-3744
Kazan Ivan W Memorial Clinic
570 E Moqui Ln
Escalante
UT 84726-0276

Ph: (435) 826-4374

NPI Details:

NPI Number1568886000
Provider Enumeration Date02/04/2014
Last Update Date04/21/2021

Medicare PECOS Information:

Medicare PECOS PAC ID1254242233
Medicare Enrollment IDO20140414001659

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Medical Identifiers

Medical identifiers for Kazan Ivan W Memorial Clinic such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1568886000NPI-NPPES
000055193OtherUTMEDICARE PART B -

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261QC1500XClinic/center - Community Health (* (Not Available))Secondary
261QF0400XClinic/center - Federally Qualified Health Center (fqhc) (* (Not Available))Primary
261QM1300XClinic/center - Multi-specialty (* (Not Available))Secondary

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Clinic/Center in Escalante, UT

Kazan Ivan W. Memorial Clinic
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 65 N Center, Escalante, UT 84726
Phone: 435-826-4374    

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