Individual
KYLE EVAN GUBLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MMSC, PA-C
Contact information
Practice address
UNIVERSITY OF UTAH CARDIOTHORACIC SURGERY, 30 N 1900 E, SUITE 3C127, SALT LAKE CITY, UT 84132-3626
(801) 585-1864
Mailing address
PO BOX 27128, 30 N 1900 E, SUITE 3C127, SALT LAKE CITY, UT 84127-0128
(801) 209-2632
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7898193-1206
UT
363AS0400X
Surgical Physician Assistant
7898193-1206
UT
Other
Enumeration date
02/22/2011
Last updated
01/11/2016
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