NPI 1891008777

Grant A. Fairbanks, MD PC

Organisation Plastic Surgery Physician Bountiful, UT

Practice location

Address: 520 Medical Dr Suite 210, Bountiful, UT 84010-4968
Phone: (801) 268-8838
Mailing address: PO Box 1071, Bountiful, UT 84011-1071

Authorised official

Name: Grant a Fairbanks
Title: Provider
Phone: (801) 701-8688

Registered specialties

Plastic Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208200000X Licence 2744901205 (UT)

Other Plastic Surgery providers in Utah →

Registry record

NPI: 1891008777
Entity type: Organization
NPI issued: 20 Jul 2010
Record last updated: 20 Nov 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.