Kimball Lael Christianson, MD
Kimball Lael Christianson, MD is a Diagnostic Radiology in Provo, Utah. Graduated from Vanderbilt University School of Medicine in 2005, 21 years ago. Practices with Revere Health PC, a 410-clinician group and accepts Medicare assignment. Licensed in Idaho, North Carolina, Oregon and Utah.
- Years since qualifying
- 21
- Trained at
- Vanderbilt University School of Medicine
- Licensed in
- ID, NC, OR, UT
- In the registry since
- 2008
- Specialties on file
- 5
What do these letters mean?
- MD — Doctor of Medicine
- A physician who completed allopathic medical school.
Practice location Address checks out
1055 N 500 W Ste 112 Bldg CProvo, UT 84604
Phone: (801) 812-4624
Fax: (801) 812-4699
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Diagnostic Radiology Physician (primary) | Taxonomy 2085R0202X · Licence 10926114-1205 (UT) |
|---|---|
| Diagnostic Radiology Physician | Taxonomy 2085R0202X · Licence 2010-00277 (NC) |
| Diagnostic Radiology Physician | Taxonomy 2085R0202X · Licence MD153988 (OR) |
| Diagnostic Radiology Physician | Taxonomy 2085R0202X · Licence M-11249 (ID) |
| Student in an Organized Health Care Education/Training Program | Taxonomy 390200000X · Licence 135137 (NC) |
Record details
| NPI number | 1316113228 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | MD |
| Sole proprietor | No |
| NPI enumerated | May 1, 2008 |
| Last updated in NPPES | December 8, 2023 |
| Certification date | December 8, 2023 |
Medicare enrollment
| Medicare specialty | DIAGNOSTIC RADIOLOGY |
|---|---|
| Medical school | VANDERBILT UNIVERSITY SCHOOL OF MEDICINE |
| Graduated | 2005 (21 years in practice) |
| Group practice | Revere Health Pc — 410 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
Other providers in Provo
-
Dr. Derek Scott Bergeson, MD
1055 N 500 W Attn Credentialing, Provo, UT 84604-8460 · (801) 354-8225
-
Carl M Black, MD
1034 N 500 W, Provo, UT 84604-3380 · (801) 357-4423
-
Dr. Seth Cardall, MD
1034 N 500 W, Provo, UT 84604-3380 · (801) 225-6246
-
Brent C Chandler, MD
1034 N 500 W, Provo, UT 84604-3380 · (801) 373-7850
-
Dr. Daniel Lyman Corey, MD
1034 N 500 W, Provo, UT 84604-3380 · (801) 225-6246
-
Dr. David R Cottam, MD
1034 N 500 W, Provo, UT 84604-3380 · (801) 224-3555
-
Tyler L Crawford, MD
1034 N 500 W, Provo, UT 84604-3380 · (801) 373-7850
-
Fred Jeston Dawson, MD
1055 N 500 W Ste 112, Provo, UT 84604-3305 · (801) 812-4624