George W Delavan, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

160530-1205 Issued in UT

Practice address

44 N Mario Capecchi Dr
Salt Lake City, UT 84132-0001

Phone

(801) 584-8239

Fax

(801) 584-8588

NPI assigned

Oct 5, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330560000000",
    "number": "1013003904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2691 COMANCHE CIR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841082807",
            "telephone_number": "801-581-1258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 N MARIO CAPECCHI DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320001",
            "telephone_number": "801-584-8239",
            "fax_number": "801-584-8588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELAVAN",
        "first_name": "GEORGE",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2012-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "UT",
            "license": "160530-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "999000021002",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF UTAH DEPT. OF HEALTH",
            "identifier": "876000545",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathryn Louise Delaney, APRN
• Kelsie A. Delaney, MD
• Staci Delaney
• Christy Jamie Delaplaine
• Kristin Delatorre
• Nazir Delawar, M.D.
• Brandon William Deleeuw
• Alejandra Deleon Ruiz
• Erica Deleon, MS
• Cathie Hanes Delewski, LCSW

• Pediatrics Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Pediatrics Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.