Healthcare Provider Details

I. General information

NPI: 1538226600
Provider Name (Legal Business Name): RICHARD FRANCIS LABASKY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 S 200 E
SLC UT
84111-3835
US

IV. Provider business mailing address

PO BOX 9395
SALT LAKE CITY UT
84109-0395
US

V. Phone/Fax

Practice location:
  • Phone: 801-359-2256
  • Fax:
Mailing address:
  • Phone: 801-712-7915
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number172098-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: