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

Pediatric Adolescent Medicine Department of Univeristy of Utah

Organization Pediatrics Physician · NPI 1639123896

Pediatric Adolescent Medicine Department of Univeristy of Utah is a Pediatrics Physician in Salt Lake City, Utah. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
2

Practice location Address checks out

50 N Medical Dr
Salt Lake City, UT 84132-0001
Phone: (801) 581-3501
Fax: (801) 581-4920
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Adolescent Medicine Physician (primary) Taxonomy 2080A0000X
Pediatrics Physician Taxonomy 208000000X

Record details

NPI number1639123896
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Edward Clark — Chair · (801) 587-7400
NPI enumeratedMay 20, 2006
Last updated in NPPESSeptember 6, 2011
Mailing address295 Chipeta Way, Peds Admin, Salt Lake City, UT 84108-1220

Other providers in Salt Lake City