Organization
SHRINERS HOSPITALS FOR CHILDREN
Active
Other names
Shriners Hospitals for Children (Professional Services)
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY GANTT (PRESIDENT)
(813) 281-0300
Entity
Organization
Contact information
Practice address
3101 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3009
(503) 294-3230
(503) 221-3701
Mailing address
PO BOX 8500, LOCKBOX #7642, PHILADELPHIA, PA 19178-7642
(503) 294-3230
(503) 221-3701
Taxonomy
Speciality
Code
Description
License number
State
207XP3100X
Pediatric Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
07/22/2013
Last updated
04/19/2022
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