Grant A. Fairbanks, MD PC

NPI #1891008777 in Bountiful, Utah

Provider Information

NPI Number: 1891008777
Entity Type: Organization
Organization Name: Grant A. Fairbanks, MD PC
Primary Specialty: Plastic Surgery
Enumeration Date: Jul 20, 2010
Last Updated: Nov 20, 2015

Practice Location

Address: 520 MEDICAL DR
Address 2: SUITE 210
City: Bountiful
State: Utah
ZIP Code: 84010-4968
Phone: (801) 268-8838

Authorized Official

Name: GRANT A FAIRBANKS
Title: PROVIDER
Phone: (801) 701-8688

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Plastic Surgery	208200000X	Primary

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