Provider Demographics
NPI:1952456907
Name:RED ROCK NEUROPSYCHIATRY PC
Entity Type:Organization
Organization Name:RED ROCK NEUROPSYCHIATRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KENT
Authorized Official - Middle Name:
Authorized Official - Last Name:ROUNDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:435-656-2459
Mailing Address - Street 1:1240 E 100 S
Mailing Address - Street 2:SUITE 15A
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-3001
Mailing Address - Country:US
Mailing Address - Phone:435-656-2459
Mailing Address - Fax:
Practice Address - Street 1:1240 E 100 S
Practice Address - Street 2:SUITE 15A
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-3001
Practice Address - Country:US
Practice Address - Phone:435-656-2459
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5852286-12052084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1619932175OtherNPI INDIVIDUAL
UT1619932175OtherNPI INDIVIDUAL