Individual
STEPHEN L. RICHINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
711 RIGBY LAKE DR, STE. 114, RIGBY, ID 83442-5229
(208) 234-1300
(208) 234-1333
Mailing address
1448 E CENTER ST, SUITE E, POCATELLO, ID 83201-4105
(208) 234-1300
(208) 234-1333
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA-931
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
328390099
—
ME
01
—
970027996
RAILROAD MEDICARE
ME
01
—
P00993652
MEDICARE RAILROAD
ID
Enumeration date
06/19/2006
Last updated
06/29/2022
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