DR. GERALD IRA POLUKOFF (NPI# 1215020045) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215020045 |
| Entity Type | Individual |
| Full Name | DR. GERALD IRA POLUKOFF |
| Credential | MD |
| Practice Address |
1300 N 500 E Logan UT 84341-2408 |
| Mailing Address |
Po Box 27128 Salt Lake City UT 84127-0128 |
| Practice Telephone | 4357162200 |
| Mailing Telephone | 4357162200 |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2016-06-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
M9904 | ID | Allopathic & Osteopathic Physicians |
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
370398-1205 | UT | Allopathic & Osteopathic Physicians |
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
M-9904 | ID | Allopathic & Osteopathic Physicians |
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
370398-1205 | UT | Allopathic & Osteopathic Physicians |
| Street Address |
1300 N 500 E |
| City | LOGAN |
| State | UT |
| Zip Code | 84341-2408 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043210248 | Trek Lyons | Family Medicine | 1300 N 500 E, Suite 130, Logan, UT 84341-2408 | 2005-07-28 |
| 1285277103 | Allison Ewing Saunders | Physical Therapy Assistant | 1300 N 500 E, Logan, UT 84341-2408 | 2019-10-23 |
| 1649790114 | Candace Lee Slater | Physical Therapist | 1300 N 500 E, Logan, UT 84341-2408 | 2017-06-26 |
| 1972048569 | Lindsey Hunsaker | Speech-Language Pathologist | 1300 N 500 E, Logan, UT 84341-2408 | 2017-01-05 |
| 1629510086 | Sarah Harrison | Physical Therapist | 1300 N 500 E, Logan, UT 84341-2408 | 2016-11-15 |
| 1346612983 | Jamie Mcfarland | Nurse Practitioner | 1300 N 500 E, Suite 320, Logan, UT 84341-2408 | 2015-10-22 |
| 1760864193 | Mark Tureson | Physical Therapy Assistant | 1300 N 500 E, Logan, UT 84341-2408 | 2015-06-22 |
| 1922491430 | Kaye Marie Smith | Nurse Practitioner | 1300 N 500 E, Logan, UT 84341-2408 | 2015-03-07 |
| 1467851998 | Ryan Buck | Nurse Practitioner | 1300 N 500 E, Suite 320, Logan, UT 84341-2408 | 2014-08-20 |
| 1801114459 | Ihc Health Services Inc | Internal Medicine | 1300 N 500 E, Suite 320, Logan, UT 84341-2408 | 2010-05-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538701529 | Aubrey Salmond | Registered Nurse | 500 East 1500 N, Logan, UT 84341 | 2019-10-11 |
| 1043702046 | Eye Pros of Logan LLC | Optometrist | 1475 N Main St Ste 103, Logan, UT 84341 | 2018-06-05 |
| 1275050452 | Rylie Jeanne Cook | Student in an Organized Health Care Education/Training Program | 11 Aggie Village Apt. J, Logan, UT 84341 | 2017-08-28 |
| 1093262156 | Jessica Lynn Mcgarry | Social Worker | 1040 N 130 W, Apt 100, Logan, UT 84341 | 2016-09-07 |
| 1740663566 | Paul R Gregory | Occupational Therapy Assistant | 1300 N 500 E Suite 120, Suite 120, Logan, UT 84341 | 2015-06-30 |
| 1851708846 | Bradley Budge | Optometrist | 535 E 1400 N Ste 130, Logan, UT 84341 | 2014-07-22 |
| 1386058709 | Daniel Raymond Carlson | Physician Assistant | 500 E. 1400 N., Logan, UT 84341 | 2014-06-13 |
| 1902220239 | Work Injury Solutions Inc. | Clinic/Center | 630 E 1400 N Ste 140, Logan, UT 84341 | 2014-02-06 |
| 1750627287 | Lee Martin Williams Sr. | Counselor | 186 E. 1800 N., North Logan, UT 84341 | 2013-01-03 |
| 1669747804 | Ronald J Payne | Internal Medicine | 1726 North 1850 East, North Logan, UT 84341 | 2012-03-21 |
| Find all providers in zip 84341 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982828042 | Capitol City Cardiology, Inc. | Internal Medicine | 664 Ste. Rt. 664 N, Logan, OH 43138 | 2007-04-12 |
| 1801114459 | Ihc Health Services Inc | Internal Medicine | 1300 N 500 E, Suite 320, Logan, UT 84341-2408 | 2010-05-06 |
| 1265517858 | John T Tiano | Internal Medicine | 20 Hospital Drive, Logan, WV 25601-0000 | 2006-10-25 |
| 1255447538 | William L Saul | Internal Medicine | 1300 N 500 E, Suite 320, Logan, UT 84341-2408 | 2006-08-21 |
| 1003922394 | Rudolf Otrusinik | Internal Medicine | 1300 N 500 E, Suite 320, Logan, UT 84341-2408 | 2006-08-21 |
| 1316978745 | Mamidi Cardiology Pllc | Internal Medicine | 20 Hospital Dr, Logan, WV 25601 | 2006-07-05 |
| 1669440269 | Brian G Crandall | Internal Medicine | 1300 N 500 E, Ste 320, Logan, UT 84341-2408 | 2006-03-09 |
| 1225023088 | Robert Jackson Garr | Internal Medicine | 1300 N 500 E, Suite 320, Logan, UT 84341-2408 | 2005-09-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225681166 | Motivational Medicine | Internal Medicine | 621 E Mayor Place Dr, American Fork, UT 84003-8015 | 2019-07-19 |
| 1972026227 | Castleview Physician Practice, LLC | Internal Medicine | 945 W Hospital Dr Ste 3, Price, UT 84501-4230 | 2017-07-19 |
| 1134470347 | Lynn R Nimer, Md, A Professional Corporation | Internal Medicine | 1380 East Medical Center Ste 3500, St. George, UT 84790-2123 | 2012-09-27 |
| 1003189622 | Mehmet Akkaya | Internal Medicine | University of Utah Hospital Cardiology, 3o N,1900 E, Rm:4a100, Salt Lake City, UT 84132-0001 | 2012-02-13 |
| 1700199627 | Majd Ibrahim | Internal Medicine | 30 N Medical Dr Rm 4a100, Salt Lake City, UT 84132 | 2010-07-20 |
| 1588804314 | Michael John Preece | Internal Medicine | 1064 Donner Way, Salt Lake City, UT 84108-2507 | 2009-03-06 |
| 1902071673 | John Joseph Ryan | Internal Medicine | Division of Cardiology University of Utah, 50 North Medical Dr, Salt Lake City, UT 84132-0100 | 2008-04-24 |
| 1831364561 | Lowell Chang | Internal Medicine | 30 N Medical Dr, Salt Lake City, UT 84132-0001 | 2008-04-23 |
| 1326226671 | Deborah Budge | Internal Medicine | 5121 So. Cottonwood Drive, J.l. Sorenson Heart & Lung Center, Lower Level One, Murray, UT 84107-5701 | 2008-02-07 |
| 1942486915 | Grant L Christian Md A Professional Corporation | Internal Medicine | 425 Medical Dr Ste 118, Bountiful, UT 84010-8914 | 2008-01-21 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.