Individual
KELLEY FULGHUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
181 E MEDICAL TOWER DR, MURRAY, UT 84107-4886
(801) 442-3059
Mailing address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0001
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
9149493-1205
UT
Other
Enumeration date
04/08/2013
Last updated
05/23/2017
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