Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Granger Medical Clinic PC

Organization Dermatology Physician · NPI 1174968051

Granger Medical Clinic PC is a Dermatology Physician in Draper, Utah. Registered with an NPI since 2013.

In the registry since
2013
Specialties on file
15
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

11724 S State St
Draper, UT 84020
Phone: (801) 965-3600
Fax: (801) 965-3740
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Dermatology Physician Taxonomy 207N00000X
Internal Medicine Physician Taxonomy 207R00000X
Gastroenterology Physician Taxonomy 207RG0100X
Nephrology Physician Taxonomy 207RN0300X
Pulmonary Disease Physician Taxonomy 207RP1001X
Sports Medicine (Internal Medicine) Physician Taxonomy 207RS0010X
Sleep Medicine (Internal Medicine) Physician Taxonomy 207RS0012X
Obstetrics & Gynecology Physician Taxonomy 207V00000X
Ophthalmology Physician Taxonomy 207W00000X
Orthopaedic Surgery Physician Taxonomy 207X00000X
Otolaryngology Physician Taxonomy 207Y00000X
Pediatrics Physician Taxonomy 208000000X
Plastic Surgery Physician Taxonomy 208200000X
Pain Medicine Physician Taxonomy 208VP0000X

Record details

NPI number1174968051
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationGranger Medical Clinic PC
Authorized official Mary Jane Pennington — President · (801) 965-3600
Other names Granger Medical Draper; Granger Medical Draper
NPI enumeratedMay 6, 2013
Last updated in NPPESDecember 13, 2023
Certification dateDecember 13, 2023
Mailing address2965 W 3500 S, West Valley City, UT 84119-3602

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