Organization · NPI-2

Gordon R. Kimball M.D.,p.C.

Orthopaedic Surgery · Sandy, UT

NPI number1316270655
StatusActive
Last updated in NPPESJul 13, 2010

Details

NPI
1316270655
Entity type
Organization (NPI-2)
Legal business name
Gordon R. Kimball M.D.,p.C.
Organization subpart
No
Enumeration date
Sep 17, 2009
Last updated
Jul 13, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207X00000X Orthopaedic Surgery0551110013UTYes
363AS0400X Physician Assistant, Surgical1093777047UT

Other names

  • Lone Peak Orthopedics (Doing Business As)

Practice location

9844 S 1300 E
Suite 275
Sandy, UT 84094-4673

Phone 801-571-7061 · Fax 801-572-4564

Mailing address

9844 S 1300 E
Suite 275
Sandy, UT 84094-4673

Phone 801-571-7061 · Fax 801-572-4564

Authorized official

Carma H Morgan
Office Manager
8015717061

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