Fayard, Shawn
Fayard, Shawn is an sole proprietor health care provider with primary practice located at 103 Medical Park , Hattiesburg MS 39401-9042. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as his primary health care specialty. Fayard, Shawn can be contacted via phone (601) 268-5630.Contact Information
Primary practice address
103 Medical Park
Hattiesburg MS 39401-9042
Phone: (601) 268-5630
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer | 2255A2300X | AT0472 | Mississippi |
Profile Details
NPI number | 1689908352 |
---|---|
LBN Legal business name | Fayard, Shawn |
Credentials | Athletic Trainer, Certified (ATC) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Sep 28th, 2009 |
Last updated | Oct 20th, 2020 - about 5 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1689908352 | NPPES |
Mississippi | Other | 010702011 | NATIONAL ATHLETIC TRAINER'S ASSOCIATION BOARD OF CERTIFICATION (NATABOC) |
Mississippi | Other | AT0472 | NATIONAL ATHLETIC TRAINER'S ASSOCIATION BOARD OF CERTIFICATION (NATABOC) |
Mississippi | Other | 1005471 | NATIONAL ATHLETIC TRAINER'S ASSOCIATION BOARD OF CERTIFICATION (NATABOC) |
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