Organization · NPI-2
Direct Pay Pediatrics
Pediatrics · Sandy, UT
NPI number1003678178
StatusActive
Last updated in NPPESMar 19, 2024
Details
- NPI
- 1003678178
- Entity type
- Organization (NPI-2)
- Legal business name
- Direct Pay Pediatrics
- Organization subpart
- No
- Enumeration date
- Jan 25, 2024
- Certification date
- Mar 19, 2024
- Last updated
- Mar 19, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208000000X | Pediatrics | – | – | Yes |
| 207Q00000X | Family Medicine | – | – |
Other names
- Direct Care Pediatrics (Doing Business As)
Practice location
1434 E 9400 S Ste 100Sandy, UT 84093-2909
Phone 385-463-2757 · Fax 385-488-0693
Mailing address
1434 E 9400 S Ste 100Sandy, UT 84093-2909
Phone 385-463-2757 · Fax 385-488-0693
Authorized official
Dallin Hubbard
President
3854632757
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