Individual
KIRK R ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
1621571205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0358
DMBA
UT
01
—
04-00306
UNITED HEALTHCARE
UT
01
—
107006625101
IHC HEALTHPLANS
UT
01
—
110037852
PALMETTO GBA
UT
01
—
14053
PEHP
UT
05
—
870281028000
—
UT
01
—
870281028AN1
EMIA
UT
01
—
QM0000000034
ALTIUS
UT
Enumeration date
05/04/2006
Last updated
01/11/2010
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