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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
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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