Provider Demographics
NPI:1124209192
Name:RICHARD G SEEGMILLER DPM PC
Entity Type:Organization
Organization Name:RICHARD G SEEGMILLER DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:G
Authorized Official - Last Name:SEEGMILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:801-825-4709
Mailing Address - Street 1:1660 W ANTELOPE DR STE 110
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-1155
Mailing Address - Country:US
Mailing Address - Phone:801-825-4709
Mailing Address - Fax:801-774-0735
Practice Address - Street 1:1660 W ANTELOPE DR STE 110
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-1155
Practice Address - Country:US
Practice Address - Phone:801-825-4709
Practice Address - Fax:801-774-0735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-19
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT337246-0501213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT201163OtherALTIUS
311294OtherDESERET MUTUAL
UT529239142000Medicaid
UT52923914204001OtherREGENCE BLUE CROSS/VALUE
UT201163OtherALTIUS
UT52923914204001OtherREGENCE BLUE CROSS/VALUE
UT201163OtherALTIUS
UT52923914204001OtherREGENCE BLUE CROSS/VALUE