person
Kelly D Mikesell, PA-C
Medical Physician Assistant in West Jordan, Utah
NPI 1023200888

Kelly D Mikesell is a Medical Physician Assistant based in Provo, UT and is specialized in Medical. Kelly D Mikesell practices in West Jordan, UT and has the professional credentials of PA-C. The NPI Number for Kelly D Mikesell is 1023200888 and holds a License No. 5244260-1206 (Utah).

The current practice location address for Kelly D Mikesell is 3570 W 9000 S Ste 200, West Jordan, UT and can be reached out via phone at 801-566-9211 and via fax at 801-566-5667. You can also correspond with Kelly D Mikesell through the mailing address at 1055 N 500 W, PROVO, UT - 84604 (mailing address contact number: 801-354-8225).

Location: 3570 W 9000 S Ste 200, West Jordan, UT, 84604
person
Provider Profile Details
NPI Number
1023200888
Provider Name
Kelly D Mikesell
Credential
PA-C
Provider Entity Type
Individual
Gender
Male
Address
3570 W 9000 S Ste 200, West Jordan, UT, 84604
Phone Number
801-566-9211
Fax Number
801-566-5667
Provider Enumeration Date
08/15/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
3570 W 9000 S Ste 200
City
State
Zip
84088-8875
Phone Number
801-566-9211
Fax Number
801-566-5667
person
Provider Business Mailing Address Details
Address
3570 W 9000 S Ste 200
City
State
Zip
84088-8875
Phone Number
801-566-9211
Fax Number
801-566-5667
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
5244260-1206 (Utah)
Definition
Definition to come...
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