MEDICARE: MORGAN K GRANT MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	267959-1205	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4225	OTHER	UT	HEALTHY U
2	691577	OTHER	UT	DESERET MUTUAL
3	QM0000054865	OTHER	UT	ALTIUS
4	107004777101	OTHER	UT	IHC
5	69178	OTHER	UT	PEHP
6	870666269GRA	OTHER	UT	EDUCATORS MUTUAL
7	190683600	OTHER	UT	US DEPT OF LABOR
8	26795912000001	OTHER	UT	BCBS
9	TPRA08709	OTHER	UT	MOLINA

General Provider Information

NPI Number	:	1700983038
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MORGAN K GRANT MD

Provider Business Mailing Address
First Line	:	4292 W JOSHUA LN
Second Line	:
City	:	CEDAR HILLS
State	:	UT
Zip	:	84062-8056
Country	:	US
Telephone Number	:	801-358-4663
Fax Number	:

Provider Business Practice Location Address
First Line	:	320 RIVER PARK DR STE 125
Second Line	:
City	:	PROVO
State	:	UT
Zip	:	84604-6065
Country	:	US
Telephone Number	:	801-437-4500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	06/15/2011

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Directions to “ MORGAN K GRANT MD” Practice Location

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