# DR. RICHARD WAYNE MICKELSEN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1740250372
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084P0800X | Psychiatry Physician | 5336032-1205 | UT | — |
| 2084P0804X | Child & Adolescent Psychiatry Physician | 5336032-1205 | UT | Yes |

## Other

- **Enumeration date:** 01/25/2006
- **Last updated:** 02/18/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | U001 | BLUE CROSS | UT |
| 01 | — | U002 | DESERET MUTUAL | UT |
| 01 | — | U003 | EDUCATORS MUTUAL | UT |
| 01 | — | U006 | INTERMOUTAIN HEALTH CARE | UT |
| 01 | — | U009 | CHAMPUS | UT |