Provider Demographics
NPI:1295831915
Name:JARNAGIN, KYLE F (MD)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:F
Last Name:JARNAGIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:391 S CHIPETA WAY STE C
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84108-1294
Mailing Address - Country:US
Mailing Address - Phone:801-581-4800
Mailing Address - Fax:
Practice Address - Street 1:391 S CHIPETA WAY STE C
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84108-1294
Practice Address - Country:US
Practice Address - Phone:801-581-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01062598A208D00000X
UT11898819-12052083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice