Individual
DR. RICHARD J HOLMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2230 N UNIVERSITY PKWY, SUITE 1A, PROVO, UT 84604-1509
(801) 377-3413
(801) 655-1890
Mailing address
2230 N UNIVERSITY PKWY, SUITE 1A, PROVO, UT 84604-1509
(801) 377-3413
(801) 655-1890
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
30867671205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000057007
MEDICARE ID PIN
UT
01
—
0004610165
AETNA
UT
01
—
0101468
UNITED HEALTHCARE
UT
01
—
107008793104
SELECTHEALTH
UT
05
—
1083601942
—
UT
01
—
356679
DMBA
UT
Enumeration date
10/05/2005
Last updated
07/01/2013
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