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KELLY W HUBBARD MD PC NPI 1770779985


NPI Information

NPI: 1770779985
Provider Name: KELLY W HUBBARD MD PC
Classification: Dermatology - 207N00000X
Entity Type: Organization

CLIA Number: 46D2175159

Address:
2380 N 400 E
STE B
LOGAN, UT
ZIP 84341
Phone: (435) 752-5741
Get Directions

KELLY W HUBBARD MD PC is a dermatology in Logan, UT. The provider is a dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. KELLY W HUBBARD MD PC NPI is 1770779985. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

2380 N 400 E
STE B
LOGAN, UT
ZIP 84341-749
Phone: (435) 752-5741

The provider's authorized official is Tracey Kartsone .
The authorized official title is Accounts Manager and has the following contact phone number (435) 753-1600.

The CLIA number assigned to this NPI record is 46D2175159 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 9/20/2007 and was last updated on 11/8/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207NP0225XDermatologyPediatric Dermatology3085198-1208UTAHNo
2207NS0135XDermatologyProcedural Dermatology3085198-1205UTAHNo
3207NI0002XDermatologyClinical & Laboratory Dermatological Immunology3085198-1205UTAHNo
4207N00000XDermatology3085198-1205UTAHYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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