Provider Demographics
NPI:1962596668
Name:YARGER, RICHARD J (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:J
Last Name:YARGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:280 N HOSPITAL DR
Mailing Address - Street 2:SUITE 5
Mailing Address - City:PRICE
Mailing Address - State:UT
Mailing Address - Zip Code:84501-4216
Mailing Address - Country:US
Mailing Address - Phone:435-637-4590
Mailing Address - Fax:435-637-4598
Practice Address - Street 1:280 N HOSPITAL DR
Practice Address - Street 2:SUITE 5
Practice Address - City:PRICE
Practice Address - State:UT
Practice Address - Zip Code:84501-4216
Practice Address - Country:US
Practice Address - Phone:435-637-4590
Practice Address - Fax:435-637-4598
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IDM89612086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTU000073132Medicare UPIN
D33947Medicare UPIN