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General NPI Number Information
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NPI Number | 1649481151
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Entity Type | Organization
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Legal Business Name | KATHLEEN K BOYNTON MD PC
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Dates
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Enumeration Date | 05/25/2007
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Last Update Date | 11/25/2008
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Provider Practice Location Address
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Address Line | 3584 W. 9000 S. 300
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City | WEST JORDAN
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State | UT
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Zip | 84088
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Country | US
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Telephone | 801-563-5121
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Fax | 801-565-3663
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Provider Business Mailing Address
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Address Line | 3584 W. 9000 S. 300
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City | WEST JORDAN
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State | UT
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Zip | 84088
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Country | US
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Telephone | 801-563-5121
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Fax | 801-565-3663
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Authorized Official
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Title or Position | PHYSICIAN
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Name | KATHLEEN KARN BOYNTON
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Credential | MD
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Telephone | 801-563-5121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 178452-1205
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License Number State | UT
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