Individual
DR. KENNETH R BROADBENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1140 E 3900 S, #360, SALT LAKE CITY, UT 84124-1228
(801) 264-8686
(801) 264-8962
Mailing address
1140 E 3900 S, #360, SALT LAKE CITY, UT 84124-1228
(801) 264-8686
(801) 264-8962
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2677572-1205
UT
Other
Enumeration date
11/17/2005
Last updated
07/26/2013
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