Individual
KELLY ANN KOGUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., P.C.
Contact information
Practice address
653 N TOWN CENTER DR, SUITE 507, LAS VEGAS, NV 89144-0514
(702) 233-8101
(702) 242-0726
Mailing address
653 N TOWN CENTER DR, SUITE 507, LAS VEGAS, NV 89144-0514
(702) 233-8101
(702) 242-0726
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
9338
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002018507
—
NV
Enumeration date
07/21/2005
Last updated
01/15/2008
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