Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. GREGORY L STAKER, MD
Active Sole ProprietorDR. GREGORY L STAKER, MD is a Pediatrics healthcare provider located in ROOSEVELT, Utah. NPI 1275593717 is currently active in the NPPES registry. Verify at CMS.
Pediatrics · ROOSEVELT, UT
Registration Details
- NPI Number
- 1275593717
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 27, 2006 (20.347750118344 yrs)
- Last Updated
- Jun 28, 2017
- Licenses
-
49110821205 (UT)49110821205 (UT)
- Sole Proprietor
- Yes
Practice Information
- Address
-
210 W 300 N 75-3ROOSEVELT, UT, 84066Browse UT providers · Browse ZIP 84066
- Phone
- 4357223971
- Fax
- 4357226104
- Primary Specialty
-
Pediatrics
208000000X
- Additional Specialty
- Pediatrics
Other Pediatrics Providers in ROOSEVELT, UT
| Name | Credential | NPI |
|---|---|---|
| DR. SHANNON R STAKER | MD | 1023078045 |
| DR. JASON S BEALES | MD | 1891755872 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.