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Individual

KEVIN C FUNK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5444 SOUTH GREEN STREET, MURRAY, UT 84123
(801) 262-8120
(801) 262-5721
Mailing address
5444 SOUTH GREEN STREET, MURRAY, UT 84123
(801) 262-2647
(801) 262-3897

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
354670-1205
UT
2085R0202X
Diagnostic Radiology Physician
M-5252
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003691600
ID
05
1801975461
UT
Enumeration date
11/03/2006
Last updated
09/04/2012
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