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 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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