Provider Demographics
NPI:1588611602
Name:KLOMP, STEVEN AARON (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:AARON
Last Name:KLOMP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:STEVEN
Other - Middle Name:AARON O'CONNOR
Other - Last Name:KLOMP
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
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:435-251-3670
Mailing Address - Fax:435-251-3671
Practice Address - Street 1:652 S MEDICAL CENTER DR
Practice Address - Street 2:SUITE 300
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790
Practice Address - Country:US
Practice Address - Phone:435-251-3670
Practice Address - Fax:435-251-3671
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT66807051205208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT000063361Medicare PIN