Hanks, Kevin Matthew
Hanks, Kevin Matthew is an sole proprietor health care provider with primary practice located at 1582 Elk Creek Drive , Idaho Falls ID 83404. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Hanks, Kevin Matthew can be contacted via phone (208) 542-5414.Contact Information
Primary practice address
1582 Elk Creek Drive
Idaho Falls ID 83404
Phone: (208) 542-5414
Fax: (208) 552-2708
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | 0-0401 | Idaho |
Profile Details
NPI number | 1215943295 |
---|---|
LBN Legal business name | Hanks, Kevin Matthew |
Credentials | Doctor of Osteopathy (DO) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Jul 31st, 2006 |
Last updated | Jun 5th, 2013 - about 12 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 | 1215943295 | NPPES |
Idaho | MEDICAID | 80756400 |
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