IndividualActive
Grant Fairbanks, MD
NPI 1013056357 · Plastic Surgery Physician · South Jordan, UT
Provider details
- NPI number
- 1013056357
- Entity type
- Individual
- Primary specialty
- Plastic Surgery PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 2744901205 (UT)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
10382 S Jordan Gtwy Ste 100
South Jordan, UT 84095-4135
Phone: (801) 951-8099
Fax: (801) 951-8098
Approximate (ZIP-level) locationGet directions
Mailing address
10382 S Jordan Gtwy Ste 100
South Jordan, UT 84095-4135
Registry dates
- Enumerated
- 2007-02-05
- Last updated
- 2025-04-02
- Certified
- 2025-04-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.