Provider Demographics
NPI:1902349657
Name:KELSON PHYSICIAN PARTNER'S OF LAYTON, INC.
Entity Type:Organization
Organization Name:KELSON PHYSICIAN PARTNER'S OF LAYTON, INC.
Other - Org Name:WEE CARE PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-927-1558
Mailing Address - Street 1:2086 N 1700 W
Mailing Address - Street 2:SUITE C
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041
Mailing Address - Country:US
Mailing Address - Phone:801-927-1558
Mailing Address - Fax:801-927-1591
Practice Address - Street 1:5286 S. 3500 W.
Practice Address - Street 2:SUITE A
Practice Address - City:ROY
Practice Address - State:UT
Practice Address - Zip Code:84067
Practice Address - Country:US
Practice Address - Phone:801-927-1558
Practice Address - Fax:801-927-1591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-29
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty