Pediatric Gastroenterology Department Of University Of Utah
LBN: Pediatric Gastroenterology Department Of University Of Utah
Pediatric Gastroenterology Department Of University Of Utah is an health care organization with primary practice located at 100 N Medical Dr , Salt Lake City UT 84113-1103. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Gastroenterology. Allopathic & Osteopathic Physicians / Pediatric Gastroenterology is the primary health care specialty.
Pediatric Gastroenterology Department Of University Of Utah can be contacted via phone (801) 588-3370, or through Clark, Edward B via phone (801) 587-7400.
Contact Information
Primary practice address
100 N Medical Dr
Salt Lake City UT 84113-1103
Phone: (801) 588-3370
Fax: (801) 588-2375
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | ||
| Allopathic & Osteopathic Physicians / Pediatric Gastroenterology | 2080P0206X |
Profile Details
| NPI number | 1609820232 |
|---|---|
| LBN Legal business name | Pediatric Gastroenterology Department Of University Of Utah |
| DBA Doing business as | |
| Authorized official | Clark, Edward B Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | May 19th, 2006 |
| Last updated | Sep 6th, 2011 - about 13 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1609820232 | NPPES |
| Idaho | MEDICAID | 807149700 | |
| Idaho | MEDICAID | 121245100 | |
| Idaho | MEDICAID | 100507106 |
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