Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KEVIN MANGUM, D.O.
ActiveKEVIN MANGUM, D.O. is a Sports Medicine healthcare provider located in MURRAY, Utah. NPI 1609140847 is currently active in the NPPES registry. Verify at CMS.
Sports Medicine · MURRAY, UT
Registration Details
- NPI Number
- 1609140847
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 6, 2012 (14.397135871955 yrs)
- Last Updated
- Jun 19, 2023
- Licenses
-
8164477-1204 (UT)8164477-1204 (UT)
Practice Information
- Address
-
6095 S FASHION BLVD STE 220MURRAY, UT, 841077393Browse UT providers · Browse ZIP 84107
- Phone
- 8017588735
- Fax
- 8017692092
- Primary Specialty
-
Sports Medicine
207QS0010X
- Additional Specialty
- Sports Medicine
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.