Organization Name: | PEDIATRIC ORTHOPEDIC ASSOCIATES |
NPI Number: | 1659488799 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ALAN KENDRICK STOTTS (DEPARTMENT CHAIR) |
Mailing Address: | 100 Mario Capecchi Dr Salt Lake City |
State: | UT US |
Postal Code: | 841128924 |
Phone Number: | 8015883900 |
Fax Number: | |
NPI Enumeration Date: | 08/24/2006 |
NPI Last Update Date: | 10/16/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085B0100X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Body Imaging |
Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |