Basic Information
Provider Information
NPI: 1437352135
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CALL
FirstName: KEVIN
MiddleName: DONALD
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 27128
Address2:  
City: SALT LAKE CITY
State: UT
PostalCode: 841270128
CountryCode: US
TelephoneNumber: 8013029197
FaxNumber:  
Practice Location
Address1: 30 N 1900 E
Address2:  
City: SALT LAKE CITY
State: UT
PostalCode: 841320002
CountryCode: US
TelephoneNumber: 8015856387
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/08/2007
LastUpdateDate: 01/25/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084N0400X355696-1205UTY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology

No ID Information.


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