Provider Demographics
NPI:1447280169
Name:KELSON, ROSS JAMES (MD)
Entity type:Individual
Prefix:MR
First Name:ROSS
Middle Name:JAMES
Last Name:KELSON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6028 S RIDGELINE DRIVE
Mailing Address - Street 2:#201A
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84405
Mailing Address - Country:US
Mailing Address - Phone:801-475-6520
Mailing Address - Fax:801-475-7306
Practice Address - Street 1:6028 S RIDGELINE DRIVE
Practice Address - Street 2:#201A
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84405
Practice Address - Country:US
Practice Address - Phone:801-475-6520
Practice Address - Fax:801-475-7306
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
UT771608671205207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D07284Medicare UPIN