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
Phone: (208) 524-4511
Fax: (208) 524-4540
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154682565 | NPPES |
| Idaho | Other | O-1041 | IDAHO STATE LICENSE |
| Idaho | MEDICAID | 1154682565 | IDAHO STATE LICENSE |
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