Individual
DR. BRADFORD KELLY ENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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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