Individual
GORDON R KIMBALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9844 S 1300 E, #275, SANDY, UT 84094-4692
(801) 571-7061
(801) 571-9277
Mailing address
9844 S 1300 E, #275, SANDY, UT 84094-4692
(801) 571-7061
(801) 571-9277
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
0551110013
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17640
HMO
UT
05
—
999-000-116-008
—
UT
Enumeration date
11/18/2005
Last updated
03/27/2008
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