Individual
MARK A. RICHEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1145 N 500 W, STE A4, PROVO, UT 84604
(801) 354-8225
(801) 418-0941
Mailing address
1055 N 500 W, ATTN CREDENTIALING, PROVO, UT 84604
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
12670180-1205
UT
207W00000X
Ophthalmology Physician
G58650
CA
Other
Enumeration date
12/11/2006
Last updated
11/14/2022
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