Provider Demographics
NPI:1477665834
Name:EDWARDS, ROBERT PHILIP (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:PHILIP
Last Name:EDWARDS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3340 NORTH CENTER ST #880
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-7406
Mailing Address - Country:US
Mailing Address - Phone:801-990-1911
Mailing Address - Fax:801-990-1912
Practice Address - Street 1:3741 W 12600 S
Practice Address - Street 2:RIVERTON HOSPITAL
Practice Address - City:RIVERTON
Practice Address - State:UT
Practice Address - Zip Code:84065
Practice Address - Country:US
Practice Address - Phone:801-285-4000
Practice Address - Fax:801-733-5618
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT350709-1205207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTQM0000075886OtherALTIUS
WY118950600Medicaid
UT1502954OtherUMWA
ID806744100Medicaid
NV100501898Medicaid
UTPRA04604OtherMOLINA
UT870545614ED2OtherEDUCATORS MUTUAL
UT107008371102OtherIHC
UT342376OtherDESERET MUTUAL
AZ824757Medicaid
UT84354OtherHEALTHY U
UT2090168OtherUNITED HEALTHCARE
UT73543OtherPEHP
WY118950600Medicaid
UT870545614ED2OtherEDUCATORS MUTUAL
UT107008371102OtherIHC