Provider Demographics
NPI:1235111949
Name:GROEBS, ALLISON L (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:L
Last Name:GROEBS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 MEDICAL DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-4908
Mailing Address - Country:US
Mailing Address - Phone:801-295-2888
Mailing Address - Fax:801-295-0311
Practice Address - Street 1:620 MEDICAL DR
Practice Address - Street 2:SUITE 100
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-4908
Practice Address - Country:US
Practice Address - Phone:801-295-2888
Practice Address - Fax:801-295-0311
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5077403.1205208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics