Individual
KENDELL PORTER COBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
425 E 5350 S STE 103, OGDEN, UT 84405-6901
(385) 298-0818
(801) 205-4354
Mailing address
425 E 5350 S STE 103, OGDEN, UT 84405-6901
(385) 298-0818
(801) 205-4354
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
12813168-1204
UT
207R00000X
Internal Medicine Physician
MED-RES-LIC-77254
MT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/16/2019
Last updated
06/29/2022
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