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PEDIATRIC NEUROLOGY DEPARTMENT OF UNIVERSITY OF UTAH NPI 1831290709


NPI Information

NPI: 1831290709
Provider Name: PEDIATRIC NEUROLOGY DEPARTMENT OF UNIVERSITY OF UTAH
Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Organization

Specialization: Neurology

Address:
100 N MEDICAL DR
PEDIATRIC NEUROLOGY
SALT LAKE CITY, UT
ZIP 84113
Phone: (801) 588-3300
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PEDIATRIC NEUROLOGY DEPARTMENT OF UNIVERSITY OF UTAH is a neurology psychiatry neurology in Salt Lake City, UT. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. PEDIATRIC NEUROLOGY DEPARTMENT OF UNIVERSITY OF UTAH NPI is 1831290709. 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
PEDIATRIC NEUROLOGY
SALT LAKE CITY, UT
ZIP 84113-103
Phone: (801) 588-3300
Fax: (801) 588-3392

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

The enumeration date for this NPI number is 9/25/2006 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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsNo
22084N0400XPsychiatry & NeurologyNeurologyYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
159421312MEDICAIDCOLORADO
2807147700MEDICAIDIDAHO
3121439000MEDICAIDWYOMING
4000057968MEDICARE ID-TYPE UNSPECIFIEDUTAH
5=========001MEDICAIDUTAH
6100507115MEDICAIDNEVADA

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: 11/14/2023

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