Blatter, Richard Alan

Blatter, Richard Alan is an sole proprietor health care provider with primary practice located at 2001 S Woodruff Ave Ste 4 , Idaho Falls ID 83404-6371. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Blatter, Richard Alan can be contacted via phone (208) 524-4511.

Contact Information

Primary practice address
2001 S Woodruff Ave Ste 4 Idaho Falls ID 83404-6371
Fax: (208) 524-4540
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 5315055574 Michigan
Allopathic & Osteopathic Physicians / Urology 208800000X 5101019997 Michigan
Allopathic & Osteopathic Physicians / Urology 208800000X O-1041 Michigan
Allopathic & Osteopathic Physicians / Urology 208800000X O-1041 Idaho

Profile Details

NPI number 1154682565
LBN Legal business name Blatter, Richard Alan
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 1st, 2012
Last updated Jul 21st, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154682565 NPPES
Idaho Other O-1041 IDAHO STATE LICENSE
Idaho MEDICAID 1154682565 IDAHO STATE LICENSE

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