Organization
SHRINERS HOSPITALS FOR CHILDREN
Active
Other names
Shriners Hospitals for Children (Professional Services)
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN CRAIG MARTIN (ADMINISTRATOR)
(801) 536-3700
Entity
Organization
Contact information
Practice address
1275 E FAIRFAX RD, SALT LAKE CITY, UT 84103-4324
(801) 536-3714
(801) 536-3799
Mailing address
PO BOX 8500, LOCKBOX #7642, PHILADELPHIA, PA 19178-7642
(801) 536-3714
(801) 536-3799
Taxonomy
Speciality
Code
Description
License number
State
207XP3100X
Pediatric Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
07/22/2013
Last updated
05/20/2014
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