Individual
KYLE FUSSELMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4401 HARRISON BLVD, OGDEN, UT 84403-3195
(801) 387-3364
(801) 387-7910
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
10627984-1204
UT
207R00000X
Internal Medicine Physician
207R00000X
WV
Other
Enumeration date
06/20/2015
Last updated
06/20/2025
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