1134307499 NPI number — RICHARD MCCURRY PATTEN M.D.

Table of content: FARAH MUSTAPHA PHARMD (NPI 1891311486)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134307499 NPI number — RICHARD MCCURRY PATTEN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PATTEN
Provider First Name:
RICHARD
Provider Middle Name:
MCCURRY
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1134307499
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/21/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 27128
Provider Second Line Business Mailing Address:
LDS HOSPITAL ATTN: HOSPITALISTS
Provider Business Mailing Address City Name:
SALT LAKE CITY
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84127-0128
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
801-408-5482
Provider Business Mailing Address Fax Number:
801-408-5481

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3741 W. 12600 S.
Provider Second Line Business Practice Location Address:
RIVERTON HOSPITAL
Provider Business Practice Location Address City Name:
RIVERTON
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84065
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-285-2200
Provider Business Practice Location Address Fax Number:
801-285-2211
Provider Enumeration Date:
02/08/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  6825178-1205 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208000000X , with the licence number: 6825178-1205 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208M00000X , with the licence number: 6825178-1205 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1164554069 , issued by the state of ( UT ) . This identifiers is of the category "MEDICAID".