Individual
KEVIN DALE NEWBOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3895 HARRISON BLVD, OGDEN, UT 84403-2312
(801) 387-7678
(801) 387-8538
Mailing address
36 S STATE ST, SALT LAKE CITY, UT 84111-1401
(801) 442-2000
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
8984745-4405
UT
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
8984745-4405
UT
363L00000X
Nurse Practitioner
8984745-4405
UT
363LF0000X
Family Nurse Practitioner
Primary
8984745-4405
UT
363LP2300X
Primary Care Nurse Practitioner
8984745-4405
UT
Other
Enumeration date
10/04/2018
Last updated
10/04/2018
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