NPI 1821021957 · live from the CMS NPI Registry
Kelly Allan Gomez, DPM
Podiatrist, Foot & Ankle Surgery in Provo, UT. National Provider Identifier 1821021957, active.
NPI record
| NPI | 1821021957 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Podiatrist, Foot & Ankle Surgery 213ES0103X |
| Practice location | 777 N 500 W, Suite 103, Provo, UT 84601 |
| Practice phone | 801-375-6677 |
| Enumerated | July 9, 2006 |
| Last updated | January 14, 2015 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist, Foot & Ankle Surgery primary | 213ES0103X | 367951 (UT) |
| Podiatrist | 213E00000X | 367951 (UT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.