Christianson, Kimball Lael
Christianson, Kimball Lael is an individual health care provider with primary practice located at 1055 N 500 W Suite 112, Bldg. C, Provo UT 84604. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Christianson, Kimball Lael can be contacted via phone (801) 812-4624.Contact Information
Primary practice address
1055 N 500 W Suite 112, Bldg. C
Provo UT 84604
Phone: (801) 812-4624
Fax: (801) 812-4699
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 2010-00277 | North Carolina |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | MD153988 | Oregon |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | M-11249 | Idaho |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | 135137 | North Carolina |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 10926114-1205 | Utah |
Profile Details
| NPI number | 1316113228 |
|---|---|
| LBN Legal business name | Christianson, Kimball Lael |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 1st, 2008 |
| Last updated | Dec 8th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316113228 | NPPES |
| Idaho | MEDICAID | 1306895016 |
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