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PEDIATRIC HEMATOLOGY ONCOLOGY-DEPARTMENT OF UNIVERSITY OF UTAH NPI 1295780625


NPI Information

NPI: 1295780625
Provider Name: PEDIATRIC HEMATOLOGY ONCOLOGY-DEPARTMENT OF UNIVERSITY OF UTAH
Classification: Pediatrics - 2080P0207X
Entity Type: Organization

Specialization: Pediatric Hematology-Oncology

Address:
100 N MEDICAL DR
SALT LAKE CITY, UT
ZIP 84113
Phone: (801) 588-2680
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PEDIATRIC HEMATOLOGY ONCOLOGY-DEPARTMENT OF UNIVERSITY OF UTAH is a pediatric hematology-oncology pediatrics in Salt Lake City, UT. The provider is a pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases. PEDIATRIC HEMATOLOGY ONCOLOGY-DEPARTMENT OF UNIVERSITY OF UTAH NPI is 1295780625. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

100 N MEDICAL DR
SALT LAKE CITY, UT
ZIP 84113-103
Phone: (801) 588-2680
Fax: (801) 588-2662

The provider's authorized official is Edward B Clark .
The authorized official title is Chair and has the following contact phone number (801) 587-7400.

The enumeration date for this NPI number is 5/24/2006 and was last updated on 9/6/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208000000XPediatricsNo
22080P0207XPediatricsPediatric Hematology-OncologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1807147300MEDICAIDIDAHO
2100507108MEDICAIDNEVADA
3=========001MEDICAIDUTAH
4121430600MEDICAIDWYOMING
5000057980MEDICARE ID-TYPE UNSPECIFIEDUTAH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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