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Contact Information

RANDALL J BREADY, MD
3741 W 12600 S
RIVERTON HOSPITAL
RIVERTON, UT84065
 Phone: 801-285-4000
 Fax: 801-733-5618
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
Indicates primary specialty

NPI Profile & details for RANDALL J BREADY · (Male)

NPI Number 1518079987
Status Active
Credentials MD
Entity Individual
Enumeration date 08/31/2006
Last updated 10/15/2012 - About 14 years ago
Sole proprietor 1 No
Identifiers
  • UT License # 261323-1205
  • AZ Medicaid 825747
  • ID Medicaid 806744000
  • NV Medicaid 100501895
  • WY Medicaid 118951400
  • UT Other QM0000075886 ALTIUS
  • UT Other 305405 DESERET MUTUAL
  • UT Other 870545614BR2 EDUCATORS MUTUAL
  • UT Other 99457 HEALTHY U
  • UT Other 107007689102 IHC
  • UT Other PRA04262 MOLINA
  • UT Other 73550 PEHP
  • UT Other 1502954 UMWA
  • UT Other 2090168 UNITED HEALTHCARE
Hospital affiliation(s)
  • RIVERTON HOSPITAL - (Acute Care)
    3741 WEST 12600 SOUTH
    RIVERTON, UT 84065
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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