MEDICARE: DR. BRIAN FARLEY RICHARDSON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207LP2900X	Pain Medicine (Anesthesiology) Physician	8449413-1205	UT
2	207L00000X	Anesthesiology Physician	2010-00517	NC
3	208VP0014X	Interventional Pain Medicine Physician	8449413-1205	UT

General Provider Information

NPI Number	:	1437127826
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN FARLEY RICHARDSON MD

Provider Business Mailing Address
First Line	:	PO BOX 912042
Second Line	:
City	:	ST GEORGE
State	:	UT
Zip	:	84791-2042
Country	:	US
Telephone Number	:	435-215-0230
Fax Number	:	435-986-7092

Provider Business Practice Location Address
First Line	:	630 E 1400 N STE 135
Second Line	:
City	:	LOGAN
State	:	UT
Zip	:	84341-2549
Country	:	US
Telephone Number	:	435-787-8146
Fax Number	:	435-787-8149

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2006
Last Update Date	:	02/07/2024

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