Holt, Richard Blaine

Holt, Richard Blaine is an individual health care provider with primary practice located at 1433 N 1075 W Ste 104 , Farmington UT 84025-2746. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Holt, Richard Blaine can be contacted via phone (801) 298-1300.

Contact Information

Primary practice address
1433 N 1075 W Ste 104 Farmington UT 84025-2746
Phone: (801) 298-1300
Fax: (801) 296-6199
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 1615101205 Utah

Profile Details

NPI number 1508863291
LBN Legal business name Holt, Richard Blaine
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2005
Last updated Feb 26th, 2019 - about 5 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 1508863291 NPPES
Arizona MEDICAID 922709
Arizona Other P00199683
Arizona MEDICAID 002085066
Arizona MEDICAID 05745
Arizona MEDICAID 807115900
Arizona Other P00651535
Arizona MEDICAID 120730000

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