Healthcare Provider Details

I. General information

NPI: 1487603916
Provider Name (Legal Business Name): GREGORY J LITTON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 10/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5131 COTTONWOOD ST L-2
MURRAY UT
84107-5701
US

IV. Provider business mailing address

1121 E 3900 S SUITE C-240
SALT LAKE CITY UT
84124-1214
US

V. Phone/Fax

Practice location:
  • Phone: 801-263-3416
  • Fax: 801-263-3428
Mailing address:
  • Phone: 801-266-0878
  • Fax: 801-266-2074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number176520-1205
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number176520-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: