Individual
DR. RICHARD HARRY MCILROY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4021 S 700 E, SUITE 300, SALT LAKE CITY, UT 84107-2192
(800) 328-3048
(801) 264-6463
Mailing address
551 NORTH 800 WEST, TETONIA, ID 83452
(208) 456-0984
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
9155
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12024
—
ND
Enumeration date
10/06/2006
Last updated
07/08/2007
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