University of Utah Pediatric Services

NPI #1528416047 in Salt Lake City, Utah

Provider Information

NPI Number: 1528416047
Entity Type: Organization
Organization Name: University of Utah Pediatric Services
Subpart: Yes (part of a larger organization)
Parent Organization: UNIVERSITY OF UTAH PEDIATRIC SERVICES
Primary Specialty: Pediatrics
Enumeration Date: May 25, 2016
Last Updated: May 25, 2016

Practice Location

Address: 100 N MARIO CAPECCHI DR
City: Salt Lake City
State: Utah
ZIP Code: 84113-1103
Phone: (801) 587-6336

Authorized Official

Name: EDWARD CLARK, MD
Title: DEPARTMENT CHAIR
Phone: (801) 587-6336

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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