Provider Demographics
NPI:1649229618
Name:DIFIORE, KENT C (MD)
Entity Type:Individual
Prefix:DR
First Name:KENT
Middle Name:C
Last Name:DIFIORE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1121 E 3900 S
Mailing Address - Street 2:SUITE C-240
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84124-1214
Mailing Address - Country:US
Mailing Address - Phone:801-266-0878
Mailing Address - Fax:801-266-2074
Practice Address - Street 1:3838 S 700 E
Practice Address - Street 2:SUITE 100
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84106-1466
Practice Address - Country:US
Practice Address - Phone:801-269-0231
Practice Address - Fax:801-269-0304
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2010-12-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
UT160097-1205207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT107006480101OtherSELECT HEALTH
UT05485Medicaid
UT830002643OtherRAILROAD MEDICARE
UT830002643OtherRAILROAD MEDICARE
UT005717201Medicare PIN