PEDIATRIC GASTROENTEROLOGY DEPARTMENT OF UNIVERSITY OF UTAH
NPI 1609820232
Pediatrics - Pediatric Gastroenterology in Salt Lake City, UT

Q: What is the provider's specialty?

The provider's specialty is Pediatrics with taxonomy code 2080P0206X and a focus in Pediatric Gastroenterology.

Active since May 19, 2006

100 N MEDICAL DR, SALT LAKE CITY, UT 84113(801) 588-3370(801) 588-2375 Get Directions Write a Review

NPPES record last updated: September 6, 2011. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Pediatric Gastroenterology Department Of University Of Utah NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PEDIATRIC GASTROENTEROLOGY DEPARTMENT OF UNIVERSITY OF UTAH (NPI 1609820232) is a healthcare organization registered as a pediatric gastroenterology in Salt Lake City, Utah and active in the NPI registry since May 2006. The organization lists Edward B Clark, Chair, as its authorized official.

NPPES Registry Identity

NPI1609820232

Entity TypeOrganization

Primary Taxonomy2080P0206X

Legal Business NamePEDIATRIC GASTROENTEROLOGY DEPARTMENT OF UNIVERSITY OF UTAH

Location Address100 N MEDICAL DRSalt Lake City, UT 84113-1103

Mailing Address295 Chipeta Way, Peds AdminSalt Lake City, UT 84108-1220 · (801) 587-7400 · Fax (801) 587-7417

Phone(801) 588-3370

Fax(801) 588-2375

Organization SubpartNo

Authorized OfficialEdward B ClarkChair · (801) 587-7400

Enumeration DateMay 19, 2006

Last NPPES UpdateSeptember 6, 2011

✔ NPI 1609820232 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code2080P0206X

Definition

A pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs.

Also ListedPediatricsTaxonomy 208000000X

100 N MEDICAL DR, Salt Lake City, UT 84113

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Other Identifiers 5

Medicare ID-Type Unspecified000057979UT

Medicaid=========001UT

Medicaid807149700ID

Medicaid121245100WY

Medicaid100507106NV

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›