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Mackenzie Kelly, MD — NPI 1942761580, Salt Lake City, UT | NPI Central

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NPI 1942761580

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Mackenzie Kelly, MD

NPI 1942761580 · Adult Reconstructive Orthopaedic Surgery Physician · Salt Lake City, UT

Provider details

NPI number: 1942761580
Entity type: Individual
Primary specialty: Adult Reconstructive Orthopaedic Surgery PhysicianAllopathic & Osteopathic Physicians
Credential: MD
Sex: Female
Sole proprietor: No
License: PG198843 (OR)

Specialties & taxonomies

Adult Reconstructive Orthopaedic Surgery PhysicianPrimary207XS0114XLicense 14210189-1205 (UT)
Allopathic & Osteopathic Physicians
Orthopaedic Surgery Physician207X00000XLicense PG198843 (OR)
Allopathic & Osteopathic Physicians
Surgery Physician208600000XLicense 125.073820 (IL)
Allopathic & Osteopathic Physicians
Student in an Organized Health Care Education/Training Program390200000X
Student, Health Care

Practice location

590 S Wakara Way

Salt Lake City, UT 84108-1200

Phone: (801) 581-2121

Approximate (ZIP-level) locationGet directions

More UT providers

Mailing address

590 S Wakara Way

Salt Lake City, UT 84108-1200

Additional practice locations (1)

3181 Sw Sam Jackson Park Rd
Portland, OR 97239-3098
Phone: (503) 494-8211

Registry dates

Enumerated: 2019-03-27
Last updated: 2025-12-29
Certified: 2025-12-29

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.