Healthcare Provider Details

I. General information

NPI: 1306823331
Provider Name (Legal Business Name): RICHARD L POHL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/30/2005
Last Update Date: 04/05/2021
Certification Date: 04/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

845 E 4800 S STE 200
MURRAY UT
84107-5041
US

IV. Provider business mailing address

PO BOX 682217
PARK CITY UT
84068-2217
US

V. Phone/Fax

Practice location:
  • Phone: 801-264-9522
  • Fax: 801-265-9604
Mailing address:
  • Phone: 617-335-0941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number34537
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number34537
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number9593487-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: