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Individual
LEE G KENNARD
Active
Individual
LEE G KENNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
164604-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107006657101
IHC
UT
01
—
1502954
UMWA
UT
01
—
2090168
UNITED HEALTHCARE
UT
01
—
35865
DESERET MUTUAL
UT
01
—
37800
PEHP
UT
01
—
8597445
WORKERS COMP
UT
01
—
870545614KE1
EDUCATORS MUTUAL
UT
05
—
944422
—
AZ
01
—
PRA01827
MOLINA
UT
01
—
QM0000075886
ALTIUS
UT
Enumeration date
10/03/2006
Last updated
07/08/2007
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