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Organization

RICHARD T STEVENS, MD, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RICHARD T STEVENS M.D. (OWNER)
(435) 752-0330
Entity
Organization

Contact information

Practice address
169 SPRINGCREEK PKWY, 100, PROVIDENCE, UT 84332-9707
(435) 752-0330
(435) 755-0922
Mailing address
PO BOX 609, PROVIDENCE, UT 84332-0609
(435) 752-0330
(435) 755-0922

Taxonomy

Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
61283271205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
61283271205
STATE LICENSE
UT
Enumeration date
07/08/2006
Last updated
09/12/2007
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