network|NPI|TIN|Name|FirstName|MI|LastName|Degree|Specialty|Address|City|State|Zip|Phone|TermDate|ReportDate
WISE|1437205028|870281028|REVERE HEALTH SURGERY CENTER|||||Ambulatory Surgery Center|1175 E 50 S|AMERICAN FORK|UT|84003|8013758858|2022-04-30|2022-04-15
WISE|1437205028|870281028|REVERE HEALTH SURGERY CENTER|||||Ambulatory Surgery Center|P.O. BOX 30079|SALT LAKE CITY|UT|84130|8013758858|2022-04-30|2022-04-15
WISE|1720482086|870625774|ROCKY MOUNTAIN DERMATOLOGY|SCOTT||MACDONALD|MD|Dermatology|1030 MEDICAL DR STE A STE A|BRIGHAM CITY|UT|84302|8018279100|2022-03-31|2022-04-15
WISE|1720482086|870625774|ROCKY MOUNTAIN DERMATOLOGY|SCOTT||MACDONALD|MD|Dermatology|1760 N 200 E STE 101|LOGAN|UT|84341|4357870560|2022-03-31|2022-04-15
WISE|1720482086|870625774|ROCKY MOUNTAIN DERMATOLOGY|SCOTT||MACDONALD|MD|Dermatology|1920 W 250 N STE 17 & 18|OGDEN|UT|84404|8018279100|2022-03-31|2022-04-15
WISE|1720482086|870625774|ROCKY MOUNTAIN DERMATOLOGY|SCOTT||MACDONALD|MD|Dermatology|434 E 350 S STE D|OGDEN|UT|84405|8018279100|2022-03-31|2022-04-15
WISE|1891976783|271700729|GREGORY IVERSON FAMILY MEDICINE|JASON|M|HARPER|DO|Family Practice|142 S 50 E|COALVILLE|UT|84017|4353364403|2022-01-31|2022-04-15
WISE|1891976783|271700729|GREGORY IVERSON FAMILY MEDICINE|JASON|M|HARPER|DO|Family Practice|228 W 200 S|KAMAS|UT|84036|4357834385|2022-01-31|2022-04-15