Carl Kent Hebdon MD PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

160845-1205 Issued in UT

Legal business name

CARL KENT HEBDON MD PC

Practice address

2040 Murray Holladay Rd
Suite 209
Salt Lake City, UT 84117-5185

Phone

(801) 273-0306

Fax

(801) 273-0317

NPI assigned

Oct 5, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Carl Kent Hebdon, MD

Title

Medical Director

Phone

(801) 547-1991

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Center for Performance and Longevity Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221609600000",
    "number": "1124114038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1797",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840416797",
            "telephone_number": "801-547-1991",
            "fax_number": "801-547-1929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 MURRAY HOLLADAY RD",
            "address_2": "SUITE 209",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841175185",
            "telephone_number": "801-273-0306",
            "fax_number": "801-273-0317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARL KENT HEBDON MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2008-09-17",
        "status": "A",
        "authorized_official_last_name": "HEBDON",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "KENT",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "801-547-1991",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "UT",
            "license": "160845-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529602584001",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center for Performance and Longevity",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Santiago Moises Carhuatanta
• Paloma Felga Cariello, MD
• Ani Carignan
• Vitor Gabriel Giuliani Alcantara Carioca, ATC
• Carissa Mora-Rodriguez
• Brian C Carl, PHD
• Mark J Carlberg, M.D.
• Scott Szucs Carleton, M.D
• Keren Moore Carley, PT
• Emiline Carling

• Specialist in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Specialist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.