OrganizationActive
Grant R Fairbanks MD PC
NPI 1578699039 · Plastic Surgery Physician · Salt Lake City, UT
Provider details
- NPI number
- 1578699039
- Entity type
- Organization
- Primary specialty
- Plastic Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Grant Fairbanks, Medical Doctor(801) 268-8838
- License
- 1487731205 (UT)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
1151 East 3900 South
Suite B110
Salt Lake City, UT 84124
Phone: (801) 268-8838
Fax: (801) 268-8264
Approximate (ZIP-level) locationGet directions
Mailing address
1151 East 3900 South
Salt Lake City, UT 84124
Registry dates
- Enumerated
- 2007-02-26
- Last updated
- 2008-08-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.