Individual
RICHARD L GLINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1250 E 3900 S, #30, SALT LAKE CITY, UT 84124
(801) 268-7725
Mailing address
PO BOX 271220, SALT LAKE CITY, UT 84127-1220
(801) 534-1360
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
7596444-1205
UT
208VP0014X
Interventional Pain Medicine Physician
Primary
7596444-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790794063
—
UT
Enumeration date
08/05/2006
Last updated
08/07/2018
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