Individual
KEEGAN J. COLLETIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0001
(515) 371-4649
Mailing address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0001
(515) 371-4649
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
11899045-1205
UT
207RG0100X
Gastroenterology Physician
Primary
11899045-1205
UT
207RG0100X
Gastroenterology Physician
BP10079492
TX
Other
Enumeration date
04/05/2019
Last updated
03/09/2026
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