Healthcare Provider Details

I. General information

NPI: 1477732741
Provider Name (Legal Business Name): RICHARD A CALL II MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2007
Last Update Date: 12/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3651 N 100 E STE #150
PROVO UT
84604
US

IV. Provider business mailing address

3651 N 100 E STE #150
PROVO UT
84604
US

V. Phone/Fax

Practice location:
  • Phone: 801-224-0737
  • Fax: 801-226-0832
Mailing address:
  • Phone: 801-224-0737
  • Fax: 801-226-0832

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number162202
License Number StateUT

VIII. Authorized Official

Name: RICHARD A CALL II
Title or Position: OWNER
Credential: MD
Phone: 801-226-0737