Individual
DR. KIPP MORENO ROBINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1055 N 500 W BLDG A, PROVO, UT 84604-3305
(801) 812-5033
Mailing address
1055 N 500 W, ATTN: CREDENTIALING, PROVO, UT 84604-3305
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
1811001205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107007096101
IHC PROVIDER NUMBER
UT
Enumeration date
06/23/2005
Last updated
11/27/2023
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