Basic Information
Provider Information
NPI: 1417157876
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PATILANO
FirstName: RICHARD
MiddleName: ROMERO
NamePrefix:  
NameSuffix: JR.
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 27128
Address2:  
City: SALT LAKE CITY
State: UT
PostalCode: 841270128
CountryCode: US
TelephoneNumber: 4352512992
FaxNumber:  
Practice Location
Address1: 1380 E MEDICAL CENTER DR
Address2:  
City: ST GEORGE
State: UT
PostalCode: 847902123
CountryCode: US
TelephoneNumber: 4352512992
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/23/2007
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X7604467-1205UTN Allopathic & Osteopathic PhysiciansInternal Medicine 
208M00000X01068939AINN Allopathic & Osteopathic PhysiciansHospitalist 
208M00000X7604467-1205UTY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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