Healthcare Provider Details

I. General information

NPI: 1548441207
Provider Name (Legal Business Name): KENNETH RHEIM TURLEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2007
Last Update Date: 03/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4364 WASHINGTON BLVD
OGDEN UT
84403-1866
US

IV. Provider business mailing address

150 W CIVIC CENTER DR STE 200
SANDY UT
84070-4284
US

V. Phone/Fax

Practice location:
  • Phone: 801-479-4470
  • Fax:
Mailing address:
  • Phone: 888-854-3822
  • Fax: 770-701-6673

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number35.089914
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number108600211205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: