Individual
DR. KENNETH EDWARD STEVENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5405 S 500 E STE 205, OGDEN, UT 84405-7420
(801) 479-0174
(801) 479-8888
Mailing address
PO BOX 281721, ATLANTA, GA 30384-1721
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
378676-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245326065
—
UT
Enumeration date
10/05/2006
Last updated
04/19/2023
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