Mickelsen, Richard Wayne

Mickelsen, Richard Wayne is an sole proprietor health care provider with primary practice located at 1300 E Center St , Provo UT 84606-3554. He recently has only one registered license in Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, which is considered as his primary health care specialty. Mickelsen, Richard Wayne can be contacted via phone (801) 344-4215.

Contact Information

Primary practice address
1300 E Center St Provo UT 84606-3554
Phone: (801) 344-4215
Fax: (801) 344-4225
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 5336032-1205 Utah

Profile Details

NPI number 1740250372
LBN Legal business name Mickelsen, Richard Wayne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 25th, 2006
Last updated Aug 3rd, 2023 - 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 1740250372 NPPES
Utah Other U002 DESERET MUTUAL
Utah Other U003 DESERET MUTUAL
Utah Other U001 DESERET MUTUAL
Utah Other U006 DESERET MUTUAL
Utah Other U009 DESERET MUTUAL

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