MEDICARE: DR. WENDELL G KEY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	1846191205	UT

General Provider Information

NPI Number	:	1588733729
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WENDELL G KEY MD

Provider Business Mailing Address
First Line	:	PO BOX 130
Second Line	:
City	:	MONTEZUMA CREEK
State	:	UT
Zip	:	84534-0130
Country	:	US
Telephone Number	:	435-651-3718
Fax Number	:

Provider Business Practice Location Address
First Line	:	30 WEST MEDICAL DRIVE
Second Line	:
City	:	MONUMENT VALLEY
State	:	UT
Zip	:	84536
Country	:	US
Telephone Number	:	435-727-3000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2006
Last Update Date	:	03/07/2022

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