Fauvor, Rickey Sam

Fauvor, Rickey Sam is an individual health care provider with primary practice located at 2512 N Stokesberry Pl Ste 102 , Meridian ID 83646-1135. He recently has only one registered license in Speech, Language and Hearing Service Providers / Hearing Instrument Specialist, which is considered as his primary health care specialty. Fauvor, Rickey Sam can be contacted via phone (208) 229-3238.

Contact Information

Primary practice address
2512 N Stokesberry Pl Ste 102 Meridian ID 83646-1135
Phone: (208) 229-3238
Fax: (208) 880-4245
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Hearing Instrument Specialist 237700000X HAS-P-916188 Oregon
Speech, Language and Hearing Service Providers / Hearing Instrument Specialist 237700000X HA3089 Idaho

Profile Details

NPI number 1295896835
LBN Legal business name Fauvor, Rickey Sam
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 2006
Last updated Jan 18th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295896835 NPPES
Idaho Other 82-3793314 INSURANCE
Idaho MEDICAID 82-3793314 INSURANCE

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