Individual
DR. BRENT S. CHILD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8TH AVENUE AND C STREET, LDS HOSPITAL, SALT LAKE CITY, UT 84143
(801) 507-5248
(801) 733-5618
Mailing address
3340 NORTH CENTER ST #800, LEHI, UT 84043-7406
(801) 990-1911
(801) 990-1912
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
163630-1205
UT
207L00000X
Anesthesiology Physician
79-163630-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002082843
—
NV
05
—
003619600
—
ID
01
—
107005371101
IHC
UT
05
—
110169200
—
WY
01
—
1502954
UMWA
UT
01
—
2090168
UNITED HEALTHCARE
UT
05
—
288177
—
AZ
01
—
3252
HEALTHY U
UT
01
—
36621
DESERET MUTUAL
UT
01
—
37777
PEHP
UT
01
—
8597445
WORKERS COMP FUND
UT
01
—
870545614CH2
EDUCATORS MUTUAL
UT
01
—
PRA05761
MOLINA
UT
01
—
QM0000075886
ALTIUS
UT
Enumeration date
08/05/2006
Last updated
10/15/2012
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