Individual
RICHARD BRENNAN BLACKHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5171 S COTTONWOOD ST, SUITE, 810, MURRAY, UT 84107-5704
(801) 507-9800
(801) 507-9801
Mailing address
5171 S COTTONWOOD ST, SUITE, 810, MURRAY, UT 84107-5704
(801) 505-9800
(801) 507-9801
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
46108
AZ
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
8627317-1205
UT
Other
Enumeration date
06/13/2008
Last updated
08/30/2013
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