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General NPI Number Information
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NPI Number | 1700983038
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Entity Type | Individual
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Provider Name | MORGAN K GRANT MD
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Gender | Male
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 06/15/2011
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Provider Practice Location Address
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Address Line | 320 RIVER PARK DR STE 125
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City | PROVO
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State | UT
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Zip | 84604-6065
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Country | US
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Telephone | 801-437-4500
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Fax |
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Provider Business Mailing Address
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Address Line | 4292 W JOSHUA LN
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City | CEDAR HILLS
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State | UT
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Zip | 84062-8056
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Country | US
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Telephone | 801-358-4663
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 267959-1205
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License Number State | UT
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