Organization
SHRINERS HOSPITALS FOR CHILDREN
Active
Other names
Shriners Hospitals for Children Professional Services
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY G. GANTT (PRESIDENT)
(813) 281-0300
Entity
Organization
Contact information
Practice address
1 CHILDREN'S PLAZA, 2 WEST, DAYTON, OH 45404-1815
(513) 872-6000
(513) 872-6025
Mailing address
PO BOX 8500, LOCKBOX #7642, PHILADELPHIA, PA 19178-7642
(513) 872-6052
(513) 872-6115
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
—
—
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Enumeration date
06/03/2013
Last updated
01/08/2024
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