Gomez, Kelly Allan

Gomez, Kelly Allan is an individual health care provider with primary practice located at 777 N 500 W Suite 103, Provo UT 84601. He recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, Podiatric Medicine & Surgery Service Providers / Podiatrist. Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery is his primary health care specialty. Gomez, Kelly Allan can be contacted via phone (801) 375-6677.

Contact Information

Primary practice address
777 N 500 W Suite 103 Provo UT 84601
Phone: (801) 375-6677
Fax: (801) 375-0346
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 367951 Utah
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 367951 Utah

Profile Details

NPI number 1821021957
LBN Legal business name Gomez, Kelly Allan
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 9th, 2006
Last updated Jan 14th, 2015 - about 10 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821021957 NPPES
Utah Other 000064004 MEDICARE PTAN #

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