Dr Steven Michael Kelly, MD | |
1551 Renaissance Towne Dr, Suite 310, Bountiful, UT 84010-7667 | |
(801) 295-5581 | |
(801) 295-9253 |
Full Name | Dr Steven Michael Kelly |
---|---|
Gender | Male |
Speciality | Otolaryngology - Pediatric Otolaryngology |
Location | 1551 Renaissance Towne Dr, Bountiful, Utah |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1841348240 | NPI | - | NPPES |
110583300 | Medicaid | WY | |
003084400 | Medicaid | ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207YP0228X | Otolaryngology - Pediatric Otolaryngology | 182660-1205 (Utah) | Primary |
Entity Name | Ihc Health Services Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1629260880 PECOS PAC ID: 1850209420 Enrollment ID: O20031105000079 |
Entity Name | University Of Utah Pediatric Services |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1487018974 PECOS PAC ID: 0547552473 Enrollment ID: O20160713000371 |
Mailing Address | Practice Location Address |
---|---|
Dr Steven Michael Kelly, MD 2255 N 1700 W, Suite 200, Layton, UT 84041-1140 Ph: (801) 776-2180 | Dr Steven Michael Kelly, MD 1551 Renaissance Towne Dr, Suite 310, Bountiful, UT 84010-7667 Ph: (801) 295-5581 |
Derek L Vanhille, MD Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 1551 Renaissance Towne Dr Ste 310, Bountiful, UT 84010 Phone: 801-295-5581 Fax: 801-295-9253 | |
Curt Robert Stock, M.D. Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 1551 Renaissance Towne Dr, Suite 310, Bountiful, UT 84010 Phone: 801-295-5581 Fax: 801-295-9253 | |
Dr. Joshua Brian Bradshaw, M.D. Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 1551 Renaissance Towne Dr Ste 310, Bountiful, UT 84010 Phone: 801-295-5581 Fax: 801-295-9253 | |
Dr. Demetrios Gregory Skedros, M.D. Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 1551 Renaissance Towne Dr, Suite 310, Bountiful, UT 84010 Phone: 801-295-5581 Fax: 801-295-9253 |