Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 319810-1205 | UT |
N | 207XS0106X | Orthopaedic Hand Surgeon | M-7463 | ID |
NPI | 1144219593 |
---|---|
Provider Name | Dr. Richard A St Onge |
First Address | Logan, UT 84341-1796 |
Second Address | Logan, UT 84341-1788 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
80507540 | (05) | ID |
A40655 | (02) | UT |