Grant R Fairbanks MD PC

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

1487731205 Issued in UT

Legal business name

GRANT R FAIRBANKS MD PC

Practice address

1151 East 3900 South
Suite B110
Salt Lake City, UT 84124

Phone

(801) 268-8838

Fax

(801) 268-8264

NPI assigned

Feb 26, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Grant R Fairbanks, MDNPI 1861531105

Title

Medical Doctor

Phone

(801) 268-8838

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Grant R Fairbanks, MD

  • Plastic Surgery Physician
  • Salt Lake City, UT
  • NPI 1861531105
  NPD (past) Authorized official
• Grant Andreas Fairbanks, MD

  • Plastic Surgery Physician
  • South Jordan, UT
  • NPI 1013056357
  NPD (past)

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218585600000",
    "number": "1578699039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 EAST 3900 SOUTH",
            "address_2": "SUITE B110",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84124",
            "telephone_number": "801-268-8838",
            "fax_number": "801-268-8264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 EAST 3900 SOUTH",
            "address_2": "SUITE B110",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84124",
            "telephone_number": "801-268-8838",
            "fax_number": "801-268-8264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANT R FAIRBANKS MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2008-08-13",
        "status": "A",
        "authorized_official_last_name": "FAIRBANKS",
        "authorized_official_first_name": "GRANT",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "801-268-8838",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "UT",
            "license": "1487731205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Granite School District
• Granite School District Ed
• Granite School District Hartvigsen
• Granite School District Nurses
• Granite School District Preschool
• Aleyzia M Grant
• Annie Grant
• Brett Grant, DC
• Corinne Ivy Grant, LCSW
• Ethan G. Grant, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2008; 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.