KELLY W HUBBARD MD PC

LOGAN, UT
NPI1770779985
Entity TypeOrganization
Authorized ContactTRACEY KARTSONE
Accounts Manager
435-753-1600
Organization Subpart ?No
Primary Taxonomy207N00000X Dermatology
(Licence: UT  3085198-1205)
Additional Taxonomies207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology
(Licence: UT  3085198-1205)
207NP0225X Dermatology, Pediatric Dermatology
(Licence: UT  3085198-1208)
207NS0135X Dermatology, Procedural Dermatology
(Licence: UT  3085198-1205)
Enumeration Date2007-09-20
Last Update Date2007-11-08
Business Address
KELLY W HUBBARD MD PC
2380 N 400 E STE B
LOGAN, UT 84341-1749
Phone number: 435-752-5741
Mailing Address
KELLY W HUBBARD MD PC
274 N MAIN ST
LOGAN, UT 84321-3915
Phone number: 435-753-1600
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