KELLY W HUBBARD (NPI# 1871542308) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871542308 |
| Entity Type | Individual |
| Full Name | KELLY W HUBBARD |
| Credential | M.D. |
| Practice Address |
274 N Main St Logan UT 84321-3915 |
| Practice Telephone | 4357531600 |
| Practice Fax Number | 4357539521 |
| Mailing Telephone | 4357531600 |
| Mailing Fax Number | 4357539521 |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2007-11-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 3085198-1205 | UT | Allopathic & Osteopathic Physicians |
| N | 207NI0002X |
Dermatology Specialization: Clinical & Laboratory Dermatological Immunology |
3085198-1205 | UT | Allopathic & Osteopathic Physicians |
| N | 207NP0225X |
Dermatology Specialization: Pediatric Dermatology |
3085198-1205 | UT | Allopathic & Osteopathic Physicians |
| N | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
3085198-1205 | UT | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164571543 | Kelly Leonard Hubbard | Chiropractor | 10224 Sw Park Way, Suite A, Portland, OR 97225 | 2007-01-09 |
| 1780990408 | Kelly Jo Hubbard | Nurse Practitioner | 603 S Division St, Lavaca, AR 72941-4129 | 2010-08-19 |
| 1518124130 | Kelly Crumbaker Hubbard | Speech-Language Pathologist | 3556 Riverside Dr, Bldg C, Macon, GA 31210-2509 | 2008-05-21 |
| Street Address |
274 N MAIN ST |
| City | LOGAN |
| State | UT |
| Zip Code | 84321-3915 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790788503 | James T Malouf | Orthopaedic Surgery | 274 N Main St, Logan, UT 84321-3915 | 2005-05-24 |
| 1184067373 | Joshua Tyler Christiansen | Anesthesiology | 274 N Main St, Logan, UT 84321-3915 | 2013-04-08 |
| 1376894022 | Dynamic Communication | Speech-Language Pathologist | 274 N Main St, Logan, UT 84321-3915 | 2012-09-20 |
| 1649407172 | Michael J Austin | Anesthesiology | 274 N Main St, Logan, UT 84321-3915 | 2009-06-10 |
| 1730379322 | Darren V Anderson | Anesthesiology | 274 N Main St, Logan, UT 84321-3915 | 2007-07-30 |
| 1235232646 | Edwin Marlowe Goble | Orthopaedic Surgery | 274 N Main St, Logan, UT 84321-3915 | 2006-09-07 |
| 1841214483 | Interwest Anesthesia Associates LLC | Anesthesiology | 274 N Main St, Logan, UT 84321-3915 | 2006-07-27 |
| 1336162924 | Wesley S Mortensen | Anesthesiology | 274 N Main St, Logan, UT 84321-3915 | 2006-07-25 |
| 1104852599 | Vikas Garg | Anesthesiology | 274 N Main St, Logan, UT 84321-3915 | 2006-06-25 |
| 1134174543 | Mitchell R Udy | Audiologist | 274 N Main St, Logan, UT 84321-3915 | 2006-05-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265074157 | Grant E Severe | Pharmacist | 175 E 442 N, Logan, UT 84321 | 2019-10-11 |
| 1437712585 | Gregory Scott Hansen | Pharmacist | 412 East 200 North, Logan, UT 84321 | 2019-04-15 |
| 1043701584 | Mckell Peidl | Behavior Technician | 240 E 400 N Apt 8, Logan, UT 84321 | 2018-05-21 |
| 1801331194 | Eric Dutson | Speech-Language Pathologist | 964 W 2880 S, Nibley, UT 84321 | 2016-12-22 |
| 1063805299 | Krystal Cox | Marriage & Family Therapist | 493 North 700 East, Logan, UT 84321 | 2015-03-12 |
| 1013340801 | Carly D. L. Lebaron | Marriage & Family Therapist | 95 W. 100 S., Suite 360, Logan, UT 84321 | 2013-08-15 |
| 1669710471 | Brandon Bailey | Counselor | 1465 N. 300 W., Ste. A, Brigham, UT 84321 | 2013-01-29 |
| 1871843086 | Brandi Lee Richins | Social Worker | 90 E. 200 N., Logan, UT 84321 | 2012-09-14 |
| 1922356732 | Stacy Lynn Hamilton Jones | Marriage & Family Therapist | 60 East Center Street, Suite 205, Keystone Family Solutions, Logan, UT 84321 | 2012-08-28 |
| 1992002455 | Robert Thomas Allred | Chiropractor | 944 South Highway 89/91, Logan, UT 84321 | 2011-02-18 |
| Find all providers in zip 84321 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| 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. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699172122 | Ihc Health Services Inc | Dermatology | 1350 N 500 E, Budge Clinic Dermatology, Logan, UT 84341-2400 | 2014-11-26 |
| 1598081325 | Cort D Mccaughey | Dermatology | 1350 N 500 E, Intermountain Budge Clinic, Logan, UT 84341 | 2010-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245863893 | Central Utah Dermatology | Dermatology | 861 N Main, Richfield, UT 84701 | 2020-02-21 |
| 1548810401 | Smart & Gibbs | Dermatology | 3200 W Clubhouse Dr Ste 100, Lehi, UT 84043-4325 | 2019-09-12 |
| 1043874332 | Waymore Shade LLC | Dermatology | 451 S Main St Ste 1, Springville, UT 84663-2293 | 2019-04-23 |
| 1598261869 | Tuttle Dermatology PC | Dermatology | 617 E Riverside Dr Ste 103, St George, UT 84790-8049 | 2018-04-04 |
| 1770099251 | Ihc Health Services Inc | Dermatology | 395 W Bulldog Blvd Ste 604, Provo, UT 84604-3331 | 2017-12-20 |
| 1417467986 | Red Ledges Dermatology Pllc | Dermatology | 1449 N 1400 W Ste 22, St George, UT 84770-5237 | 2017-10-10 |
| 1649724139 | University of Utah Adult Services | Dermatology | 165 N. University Ave. Farmington, Farmington, UT 84025 | 2016-08-12 |
| 1861861155 | Brent H. Goodsell, Do | Dermatology | 162 S 1100 E, American Fork, UT 84003-2817 | 2015-09-17 |
| 1912316654 | Jeanna Tachiki Ryan | Dermatology | 243 E 6100 S, Murray, UT 84107-7302 | 2014-08-07 |
| 1659785889 | Dana Rice | Dermatology | 6095 S Fashion Blvd Ste 270, Murray, UT 84107-7387 | 2014-06-16 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.