Individual
KELLY DEAN KARTCHNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1034 N 500 W, PROVO, UT 84604
(801) 993-9582
(801) 733-5618
Mailing address
2975 W EXECUTIVE PKWY, 200, LEHI, UT 84043
(801) 990-1911
(801) 990-1912
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
175823-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107005684102
IHC
UT
01
—
1502954
UMWA
UT
01
—
2090168
UNITED HEALTHCARE
UT
01
—
25553
DESERET MUTUAL
UT
05
—
276396
—
AZ
01
—
37799
PEHP
UT
01
—
8198
HEALTHY U
UT
01
—
QM0000075886
ALTIUS
UT
01
—
TPRA07308
MOLINA
UT
Enumeration date
10/04/2006
Last updated
07/08/2007
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