Provider Demographics
NPI:1215947718
Name:BELL, KENNETH GEORGE II (MD)
Entity type:Individual
Prefix:
First Name:KENNETH
Middle Name:GEORGE
Last Name:BELL
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3340 NORTH CENTER ST
Mailing Address - Street 2:#800
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-7406
Mailing Address - Country:US
Mailing Address - Phone:801-990-1911
Mailing Address - Fax:801-990-1912
Practice Address - Street 1:8TH AVENUE AND C STREET
Practice Address - Street 2:LDS HOSPITAL
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84143
Practice Address - Country:US
Practice Address - Phone:801-507-5248
Practice Address - Fax:801-733-5618
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT93-264478-1205207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT3100189OtherDESERET MUTUAL
UT45640OtherPEHP
UTTPRA07307OtherMOLINA
WY114058200Medicaid
UT2090168OtherUNITED HEALTHCARE
UT107007616101OtherIHC
AZ820763Medicaid
UT8597445OtherWORKERS COMP FUND
UT3065OtherHEALTHY U
UT870545614BE3OtherEDUCATORS MUTUAL
ID805601300Medicaid
NV002086420Medicaid
UTQM0000075886OtherALTIUS
UT45640OtherPEHP
UT3065OtherHEALTHY U
NV002086420Medicaid