Individual
DR. BRADFORD KELLY ENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
39 PROFESSIONAL WAY, SUITE 1, PAYSON, UT 84651-1675
(801) 465-4805
(801) 465-4354
Mailing address
1055 N 500 W, CREDENTIALING DEPARTMENT, PROVO, UT 84604-3305
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
1779331205
UT
207Y00000X
Otolaryngology Physician
72827
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10-00159
UNITED HEALTHCARE
UT
01
—
107006732105
IHC
UT
01
—
169404
DMBA
UT
01
—
233117
ALTIUS
UT
01
—
81446
PEHP
UT
01
—
870281028BKE
EMIA
UT
01
—
P00207619
PALMETTO
UT
Enumeration date
09/02/2006
Last updated
12/22/2022
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