Provider Demographics
NPI:1831206135
Name:STARKEY, RICHARD FREDERICK (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:FREDERICK
Last Name:STARKEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 N 6TH E
Mailing Address - Street 2:PO BOX 427
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:ID
Mailing Address - Zip Code:83647-2207
Mailing Address - Country:US
Mailing Address - Phone:208-587-9736
Mailing Address - Fax:208-587-7905
Practice Address - Street 1:805 N 6TH E
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:ID
Practice Address - Zip Code:83647-2207
Practice Address - Country:US
Practice Address - Phone:208-587-9736
Practice Address - Fax:208-587-7905
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM3395207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID57406OtherBLUE CROSS
ID10006011OtherREGENCE, BLUE SHIELD
IDC36850Medicare UPIN
ID57406OtherBLUE CROSS