Provider Demographics
NPI:1598815615
Name:FOUST, RICHARD WANDS (AUD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:WANDS
Last Name:FOUST
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 TREASURE LK
Mailing Address - Street 2:
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-9023
Mailing Address - Country:US
Mailing Address - Phone:814-470-6866
Mailing Address - Fax:
Practice Address - Street 1:252 MATCH FACTORY PL
Practice Address - Street 2:
Practice Address - City:BELLEFONTE
Practice Address - State:PA
Practice Address - Zip Code:16823-1366
Practice Address - Country:US
Practice Address - Phone:814-355-1600
Practice Address - Fax:814-355-0300
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY1022231H00000X
PAAT000019L231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAFO207010OtherBLUE CROSS AND BLUE SHIEL
FLK5455Medicare UPIN
PAR06664Medicare UPIN
PAR06664Medicare ID - Type Unspecified