ROSE CREEK PEDIATRICS LLC NPI 1750985420

NPI Information

  • NPI: 1750985420
  • Provider Name: ROSE CREEK PEDIATRICS, LLC
  • Classification: Pediatrics - 208000000X
  • Entity Type: Organization
  • CLIA Number: 46D2212842
  • Address: 4121 W 13400 S UNIT B
    RIVERTON, UT
    ZIP 84096
  • Phone: (801) 842-7366

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NPI Details

ROSE CREEK PEDIATRICS, LLC is a pediatrics in Riverton, UT. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. ROSE CREEK PEDIATRICS, LLC NPI is 1750985420. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4121 W 13400 S UNIT B
RIVERTON, UT
ZIP 84096-412
Phone: (801) 842-7366

The provider's authorized official is Woodrow Cannon Marriott .
The authorized official title is Managing Member and has the following contact phone number (801) 842-7366.

The CLIA number assigned to this NPI record is 46D2212842 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/24/2020 and was last updated on 11/24/2020.

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
1208000000XPediatricsYes

What is NPI?

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This page was last updated on: 3/30/2025

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