Kartchner, Kelly Dean

Kartchner, Kelly Dean is an individual health care provider with primary practice located at 1034 N 500 W , Provo UT 84604. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Kartchner, Kelly Dean can be contacted via phone (801) 993-9582.

Contact Information

Primary practice address
1034 N 500 W Provo UT 84604
Phone: (801) 993-9582
Fax: (801) 733-5618
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 175823-1205 Utah

Profile Details

NPI number 1184710634
LBN Legal business name Kartchner, Kelly Dean
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 4th, 2006
Last updated Jul 8th, 2007 - about 17 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 1184710634 NPPES
Utah Other 37799 PEHP
Utah Other QM0000075886 PEHP
Utah Other TPRA07308 PEHP
Utah MEDICAID 276396 PEHP
Utah Other 1502954 PEHP
Utah Other 2090168 PEHP
Utah Other 8198 PEHP
Utah Other 25553 PEHP
Utah Other 107005684102 PEHP

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