IndividualActive
Kenneth Libre, M.D.
NPI 1801873534 · Family Medicine Physician · Alta, UT
Provider details
- NPI number
- 1801873534
- Entity type
- Individual
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- License
- 328690-1205 (UT)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
10160 E Highway 210
Suite 1, Goldminer'S Daughter Lodge
Alta, UT 84092-8072
Phone: (801) 742-2273
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 8072
Alta, UT 84092-8072
Registry dates
- Enumerated
- 2005-12-23
- Last updated
- 2012-12-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.