NPI
Richard Wayne Mickelsen
NPI 1740250372
Read from the NPPES registry on October 24, 2026.
Facts
- Status
- Active
- Credential
- M.D.
- Type
- Individual
- Enumeration date
- 2006-01-25
- Last updated
- 2026-02-18
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Specialties
Licenses
- License UT
- 5336032-1205
Location
- Practice location
- 1300 E Center St
- City
- Provo UT
- Postal code
- 84606-3554
- Phone
- (801) 344-4215
- Fax
- (801) 344-4225
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
No exclusion found for this NPI in the OIG LEIE file dated October 9, 2026. Confirm on OIG's online search.
Nearby
Child and Adolescent Psychiatrists in Provo, UT. 7 with this primary taxonomy in the public file.
Other NPIs in Provo, UT. 6,087 records in the public file.
Public data from NPPES and CMS. Not a credentialing determination.
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