Provider Demographics
NPI:1538377585
Name:ALLRED, DARIN KIMBALL (DO)
Entity type:Individual
Prefix:DR
First Name:DARIN
Middle Name:KIMBALL
Last Name:ALLRED
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 27128
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-0128
Mailing Address - Country:US
Mailing Address - Phone:435-251-3600
Mailing Address - Fax:435-251-3601
Practice Address - Street 1:652 S MEDICAL CENTER DR
Practice Address - Street 2:STE 120
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-7049
Practice Address - Country:US
Practice Address - Phone:435-628-4460
Practice Address - Fax:435-628-4469
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ005142207X00000X
UT7017567-1204207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ384799Medicaid
Z126784Medicare PIN