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Yuri Valerievich Khodakov

Male

Medical Specialty

Professional ID

NPI: 1700099983
PECOS ID: 2062506785
Enrollment ID: I20070925000541
Credential(MD, DO, DPM):
Medical School:
Medical School Graduation Year: 1991

Hospital Service

Hospital CCN1: 460004
Business Name (LBN)1: Mckay Dee Hospital
Hospital CCN2: 460015
Business Name (LBN)2: Logan Regional Hospital

Medical Practices

Organization Name: Ihc Health Services Inc
Group Practice ID assigned by PECOS: 1850209420
Number of Group Practice member: 2216

Location

Address1: 200 N 400
Address2:
City: Panguitch
State: Utah
Zip Code: 84759
Phone Number: (435)676-8842

Location

Address1: 400 C St
Address2:
City: Salt Lake City
State: Utah
Zip Code: 84143
Phone Number:

Location

Address1: 4401 Harrison Blvd
Address2:
City: Ogden
State: Utah
Zip Code: 84403
Phone Number: (801)387-2800

Location

Address1: 4401 Harrison Blvs
Address2: 2895 Mckay Dee Pediatric Hospitalist
City: Ogden
State: Utah
Zip Code: 84403
Phone Number: (801)387-3740

Location

Address1: 4403 Harrison Blvd
Address2: Suite 3490
City: Ogden
State: Utah
Zip Code: 84403
Phone Number: (801)387-3880

Location

Address1: 700 S Hwy 99 3
Address2: Filmore Clinic
City: Fillmore
State: Utah
Zip Code: 84631
Phone Number: (435)743-5555

Medicare

Medicare Assignment: Yes
Report Quality of Care to Physician Quality Reporting System (PQRS): Yes
Used Electronic health record (EHR): Yes