Individual
DR. GARY L CHILD
Active
Individual
DR. GARY L CHILD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
7112893-1204
UT
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
71112893-1204
UT
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
71112893-1204
UT
208VP0014X
Interventional Pain Medicine Physician
71112893-1204
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063492304
—
UT
Enumeration date
01/20/2006
Last updated
12/14/2011
Update your record
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