Provider Demographics
NPI:1811010655
Name:FARNSWORTH, KENT WALKER (MD)
Entity Type:Individual
Prefix:
First Name:KENT
Middle Name:WALKER
Last Name:FARNSWORTH
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 1:1509 FEDERAL HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84103-4446
Mailing Address - Country:US
Mailing Address - Phone:801-521-1814
Mailing Address - Fax:
Practice Address - Street 1:1509 FEDERAL HEIGHTS DRIVE
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84103
Practice Address - Country:US
Practice Address - Phone:801-521-1814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT153956-1205207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology