Organization
GRANT R FAIRBANKS MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GRANT R FAIRBANKS MD (MEDICAL DOCTOR)
(801) 268-8838
Entity
Organization
Contact information
Practice address
1151 EAST 3900 SOUTH, SUITE B110, SALT LAKE CITY, UT 84124
(801) 268-8838
(801) 268-8264
Mailing address
1151 EAST 3900 SOUTH, SUITE B110, SALT LAKE CITY, UT 84124
(801) 268-8838
(801) 268-8264
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
1487731205
UT
Other
Enumeration date
02/26/2007
Last updated
08/13/2008
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