| Dr Steven Michael Kelly, MD | |
| 
					1551 Renaissance Towne Dr, Suite 310, Bountiful, UT 84010-7667  | |
| (801) 295-5581 | |
| (801) 295-9253 | 
| Full Name | Dr Steven Michael Kelly | 
|---|---|
| Gender | Male | 
| Speciality | Otolaryngology - Pediatric Otolaryngology | 
| Location | 1551 Renaissance Towne Dr, Bountiful, Utah | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1841348240 | NPI | - | NPPES | 
| 110583300 | Medicaid | WY | |
| 003084400 | Medicaid | ID | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207YP0228X | Otolaryngology - Pediatric Otolaryngology | 182660-1205 (Utah) | Primary | 
| Entity Name | Ihc Health Services Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1629260880 PECOS PAC ID: 1850209420 Enrollment ID: O20031105000079  | 
| Entity Name | University Of Utah Pediatric Services | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1487018974 PECOS PAC ID: 0547552473 Enrollment ID: O20160713000371  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Steven Michael Kelly, MD 2255 N 1700 W, Suite 200, Layton, UT 84041-1140 Ph: (801) 776-2180  | Dr Steven Michael Kelly, MD 1551 Renaissance Towne Dr, Suite 310, Bountiful, UT 84010-7667 Ph: (801) 295-5581  | 
Derek L Vanhille, MD Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 1551 Renaissance Towne Dr Ste 310, Bountiful, UT 84010 Phone: 801-295-5581 Fax: 801-295-9253  | |
Curt Robert Stock, M.D. Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 1551 Renaissance Towne Dr, Suite 310, Bountiful, UT 84010 Phone: 801-295-5581 Fax: 801-295-9253  | |
Dr. Joshua Brian Bradshaw, M.D. Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 1551 Renaissance Towne Dr Ste 310, Bountiful, UT 84010 Phone: 801-295-5581 Fax: 801-295-9253  | |
Dr. Demetrios Gregory Skedros, M.D. Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 1551 Renaissance Towne Dr, Suite 310, Bountiful, UT 84010 Phone: 801-295-5581 Fax: 801-295-9253  |