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Contact Information

GRANT R FAIRBANKS MD PC
1151 EAST 3900 SOUTH
SUITE B110
SALT LAKE CITY, UT84124
 Phone: 801-268-8838
 Fax: 801-268-8264
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Plastic Surgery

208200000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for GRANT R FAIRBANKS MD PC

NPI Number 1578699039
LBN Legal business name GRANT R FAIRBANKS MD PC
Authorized official GRANT FAIRBANKS - (MEDICAL DOCTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 02/26/2007
Last updated 08/13/2008 - About 18 years ago
Identifiers
UT License # 1487731205
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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