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Organization
SHRINERS HOSPITALS FOR CHILDREN
Active
Organization
SHRINERS HOSPITALS FOR CHILDREN
Active
Other names
Shriners Hospitals for Children Professional Services
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY G. GANTT (PRESIDENT)
(813) 281-0300
Entity
Organization
Contact information
Practice address
1 CHILDREN'S PLAZA, 2 WEST, DAYTON, OH 45404-1815
(513) 872-6000
(513) 872-6025
Mailing address
PO BOX 8500, LOCKBOX #7642, PHILADELPHIA, PA 19178-7642
(513) 872-6052
(513) 872-6115
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
—
—
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Enumeration date
06/03/2013
Last updated
01/08/2024
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