Healthcare Provider Details

I. General information

NPI: 1730445016
Provider Name (Legal Business Name): RICHARD BEUTLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2012
Last Update Date: 01/13/2022
Certification Date: 01/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1433 N 1075 W STE 104
FARMINGTON UT
84025-2746
US

IV. Provider business mailing address

PO BOX 25488
SALT LAKE CITY UT
84125-0488
US

V. Phone/Fax

Practice location:
  • Phone: 801-298-1300
  • Fax:
Mailing address:
  • Phone: 801-298-1300
  • Fax: 801-296-1699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License NumberMD-44241
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code2085D0003X
TaxonomyDiagnostic Neuroimaging (Radiology) Physician
License NumberMD-44241
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code2085H0002X
TaxonomyHospice and Palliative Medicine (Radiology) Physician
License NumberMD-44241
License Number StateIA
# 4
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License NumberMD-44241
License Number StateIA
# 5
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License NumberMD-44241
License Number StateIA
# 6
Primary TaxonomyN
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License NumberMD-44241
License Number StateIA
# 7
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberMD-44241
License Number StateIA
# 8
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD-44241
License Number StateIA
# 9
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberR74141
License Number StateAZ
# 10
Primary TaxonomyN
Taxonomy Code2085R0203X
TaxonomyTherapeutic Radiology Physician
License NumberMD-44241
License Number StateIA
# 11
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberMD-44241
License Number StateIA
# 12
Primary TaxonomyN
Taxonomy Code2085R0205X
TaxonomyRadiological Physics Physician
License NumberMD-44241
License Number StateIA
# 13
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License NumberMD-44241
License Number StateIA
# 14
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number12527536-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: