Individual
KEVIN L JANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3702 S STATE ST STE 107, SOUTH SALT LAKE, UT 84115-5096
(801) 288-2634
(801) 288-1186
Mailing address
3702 S STATE ST STE 107, SOUTH SALT LAKE, UT 84115-5096
(801) 288-2634
(801) 288-1186
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
6555293-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4828000340001
—
UT
Enumeration date
10/31/2005
Last updated
05/02/2024
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