Mr. Ty Dallas Mangum, PA
Mr. Ty Dallas Mangum, PA is a Physician Assistant in St George, Utah. Qualified in 2021, 5 years ago. Practices with Ihc Health Services Inc, a 3,947-clinician group and accepts Medicare assignment. Licensed in Illinois.
- Years since qualifying
- 5
- Licensed in
- IL
- In the registry since
- 2020
- Specialties on file
- 2
What do these letters mean?
- PA — Physician Assistant
- A licensed clinician who examines, diagnoses and treats under a physician's supervision.
Practice location Address checks out
St George, UTNo coordinates on file. Search this address in Google Maps
Specialties & licences
| Physician Assistant (primary) | Taxonomy 363A00000X · Licence 085008692 (IL) |
|---|---|
| Student in an Organized Health Care Education/Training Program | Taxonomy 390200000X |
Record details
| NPI number | 1194340158 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | PA |
| Sole proprietor | No |
| NPI enumerated | June 15, 2020 |
| Last updated in NPPES | January 4, 2022 |
| Certification date | January 4, 2022 |
Medicare enrollment
| Medicare specialty | PHYSICIAN ASSISTANT |
|---|---|
| Medical school | OTHER |
| Graduated | 2021 (5 years in practice) |
| Group practice | Ihc Health Services Inc — 3947 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Practice locations | 2 on file with Medicare |
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Kayla Lewis
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