Deric V Ravsten is a Psychiatry in Pocatello, Idaho. Deric V Ravsten practices all healthcare services and medical treatments related to Psychiatry. The NPI Number for Deric V Ravsten is 1154431542. The last update date is 2013-10-24.
Deric V Ravsten's current location address is 1777 E Clark St, Pocatello, Idaho. You can contact this provider via phone number 2082335433 and fax number 8772842783. The mailing address for Deric V Ravsten is 1777 E Clark St, Pocatello, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Deric V Ravsten |
|---|---|
| Address | 1777 E Clark St, Pocatello, Idaho |
| Phone Number | 2082335433 |
| Fax Number | 8772842783 |
| Sole Proprietor | N |
| Credentials | D.O. |
NPI Number Detail
| NPI Number | 1154431542 |
|---|---|
| Provider Enumeration Date | 2006-08-30 |
| Last Updated Date | 2013-10-24 |
Provider Mailing Address Detail
| Address | 1777 E Clark St |
|---|---|
| City | Pocatello |
| State | Idaho (ID) |
| Post Code | 832013357 |
| Phone Number | 2082335433 |
| Fax Number | 8772842783 |
Provider's Primary Taxonomy Detail
| Speciality | Psychiatry |
|---|---|
| Taxonomy | 2084P0800X |
| Licence No | O-290 |
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Definition: A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 10154744 | ID | REGENCE BLUE SHIELD OF ID | |
| S6444 | ID | BLUE CROSS OF IDAHO | |
| 806453300 | ID | -- |
Post Comment/ Review Below
What is the unique identification code assigned to Deric V Ravsten by the Centers for Medicare & Medicaid Services?
The Deric V Ravsten has been issued the NPI (National Provider Identifier) 1154431542. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete address where Deric V Ravsten is physically located?
The Deric V Ravsten is situated at the following address: 1777 E Clark St, Pocatello, ID 832013357.
What is Deric V Ravsten's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Deric V Ravsten is Psychiatry, and the corresponding taxonomy classification code for this specialized field is 2084P0800X.
When did Deric V Ravsten receive its 1154431542 assignment?
The Deric V Ravsten was assigned its 1154431542 on 2006-08-30, which is the date when this unique identifier was issued to the organization.
When was the information regarding Deric V Ravsten most recently updated?
The details pertaining to the Deric V Ravsten, including its address, specialty, and other relevant information, were last refreshed on 2013-10-24.