Provider Demographics
NPI:1386964716
Name:POEL, RICHARD A (DO)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:A
Last Name:POEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7149 E 200 S
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84317-9729
Mailing Address - Country:US
Mailing Address - Phone:801-745-9699
Mailing Address - Fax:801-745-3426
Practice Address - Street 1:7149 E 200 S
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84317-9729
Practice Address - Country:US
Practice Address - Phone:801-745-9699
Practice Address - Fax:801-745-3426
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-08
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT180263-1204207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine