Individual
CARL WILLIAM BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1055 N 500 W, SUITE 121, PROVO, UT 84604-3305
(801) 373-7350
(801) 812-5401
Mailing address
1055 N 500 W, CREDENTIALING DEPARTMENT, PROVO, UT 84604-3305
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
181471-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09-00096
UTAH HEALTHCARE
UT
01
—
107007443103
IHC
UT
01
—
20045128
PALMETTO
UT
01
—
68078
PEHP
UT
01
—
870281028BAC
EMIA
UT
Enumeration date
09/07/2006
Last updated
11/27/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us