Individual
KIRK RONALD STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
7396 S UNION PARK AVE STE 201, MIDVALE, UT 84047-6702
(801) 567-1400
Mailing address
166 E 5900 S STE B111, MURRAY, UT 84107-7293
(801) 268-9672
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
10476224-1206
UT
363AM0700X
Medical Physician Assistant
10476224-1206
UT
Other
Enumeration date
08/21/2017
Last updated
06/14/2021
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