# GORDON R. KIMBALL M.D.,P.C.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lone Peak Orthopedics
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316270655
- **Authorized official:** MRS. CARMA H MORGAN (OFFICE MANAGER)
- **Authorized official phone:** (801) 571-7061

## Contact information

- **Practice address:** 9844 S 1300 E, SUITE 275, SANDY, UT 84094-4673
- **Practice address phone:** (801) 571-7061
- **Practice address fax:** (801) 572-4564
- **Mailing address:** 9844 S 1300 E, SUITE 275, SANDY, UT 84094-4673
- **Mailing address phone:** (801) 571-7061
- **Mailing address fax:** (801) 572-4564

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | 0551110013 | UT | Yes |
| 363AS0400X | Surgical Physician Assistant | 1093777047 | UT | — |

## Other

- **Enumeration date:** 09/17/2009
- **Last updated:** 07/13/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1578545919 | INDIVIDUAL NPI | UT |
| 05 | — | 999000116008 | — | UT |