Richard E Black
Pediatric Surgery
100 Mario Capecchi Dr
Salt Lake City
, Utah 84113-1103
Richard E Black
Pediatric Surgery
100 Mario Capecchi Dr
Salt Lake City
, Utah 84113-1103
(801) 213-3900
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About
Features
Specialties
- Pediatric Surgery
Languages spoken
- English
Location
First Address
- Richard E Black
- Po Box 413035
- Salt Lake City, UT
- Zip : 84141-3035
- Phone : (801) 213-3900
Second Address
- Richard E Black
- 100 Mario Capecchi Dr
- Salt Lake City, UT
- Zip : 84113-1103
- Phone : (801) 662-2950
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2086S0120X | Pediatric Surgery | 1597211205 | UT |
National Provider Identifier
| NPI | 1316028103 |
|---|---|
| Provider Name | Richard E Black |
| First Address | Salt Lake City, UT 84141-3035 |
| Second Address | Salt Lake City, UT 84113-1103 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 18/10/2006 |
| Last Update Date | 03/12/2013 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 05415 | (05) | UT |
| F53847 | (02) | UT |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.