Doctor Name: | RICHARD BRENNAN BLACKHAM |
NPI Number: | 1043470990 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 46108 |
Business Practice Address: | 5171 S Cottonwood St Suite, 810 Murray, UT - 841075704 |
Business Phone Number: | 8015079800 |
Business Fax Number: | 8015079801 |
Mailing Address: | 5171 S Cottonwood St, Suite, 810 MURRAY |
State: | UT |
Postal Code: | 841075704 |
Phone Number: | 8015059800 |
Fax Number: | 8015079801 |
NPI Enumeration Date: | 06/13/2008 |
NPI Last Update Date: | 08/30/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2081P2900X |
License Number: | 46108 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | AZ |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Physical Medicine & Rehabilitation |
Taxonomy Specialization: | Pain Medicine |
Taxonomy Definition: | A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. |