Individual
ROSS KELLEY THUESON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
62 E. 3450 N., SPANISH FORK, UT 84660-5734
(801) 360-2909
Mailing address
62 E 3450 N, SPANISH FORK, UT 84660-5734
(801) 360-2909
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
17508-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
176508-1205
MEDICAL LICENSE
UT
Enumeration date
12/31/2015
Last updated
12/31/2015
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