Provider Demographics
NPI:1801101373
Name:CRITCHFIELD, GREGORY C (MD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:C
Last Name:CRITCHFIELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6170 MURDOCH WOODS PL
Mailing Address - Street 2:
Mailing Address - City:HOLLADAY
Mailing Address - State:UT
Mailing Address - Zip Code:84121-2206
Mailing Address - Country:US
Mailing Address - Phone:801-541-2322
Mailing Address - Fax:
Practice Address - Street 1:6170 MURDOCH WOODS PL
Practice Address - Street 2:
Practice Address - City:HOLLADAY
Practice Address - State:UT
Practice Address - Zip Code:84121-2206
Practice Address - Country:US
Practice Address - Phone:801-541-2322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-09
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT176973-1205207ZC0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZC0006XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology