Healthcare Provider Details

I. General information

NPI: 1679738744
Provider Name (Legal Business Name): RICHARD NELSON IRION M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2008
Last Update Date: 12/21/2024
Certification Date: 12/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5295 S COMMERCE DR STE 550
MURRAY UT
84107-4736
US

IV. Provider business mailing address

5295 S COMMERCE DR STE 550
MURRAY UT
84107-4736
US

V. Phone/Fax

Practice location:
  • Phone: 801-313-4110
  • Fax: 801-618-1583
Mailing address:
  • Phone: 801-313-4110
  • Fax: 801-618-1583

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number8588524-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: