Individual
DR. JASON ANTHONY KIRKHAM
Active
Individual
DR. JASON ANTHONY KIRKHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
5827923-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100505947
—
NV
05
—
120831400
—
WY
01
—
58279231200001
BCBSUT
UT
01
—
58279231203001
BCBSUT
UT
05
—
807205500
—
ID
05
—
D6039
—
UT
01
—
P00224687
RR MEDICARE
UT
01
—
P00651539
RR MEDICARE
UT
Enumeration date
07/15/2005
Last updated
02/26/2019
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