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Individual

DR. GARY L CHILD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
945 W 3200 N, LEHI, UT 84043-9771
(801) 766-6055
(888) 611-8840
Mailing address
945 W 3200 N, LEHI, UT 84043-9771
(801) 766-6055
(888) 611-8840

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
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