University of Utah Pediatric Services
NPI #1669918769 in Idaho Falls, Idaho
Provider Information
- NPI Number
- 1669918769
- 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
- Psychiatry & Neurology - Neurology with Special Qualifications in Child Neurology
- Enumeration Date
- Jan 12, 2017
- Last Updated
- May 21, 2020
Practice Location
- Address
- 1645 PANCHERI DR
- City
- Idaho Falls
- State
- Idaho
- ZIP Code
- 83402-3169
- Phone
- (208) 227-1460
Authorized Official
- Name
- EDWARD CLARK, MD
- Title
- DEPARTMENT CHAIR
- Phone
- (801) 587-6336
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pediatrics |
| Psychiatry & Neurology - Neurology with Special Qualifications in Child Neurology — Neurology with Special Qualifications in Child Neurology |
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