MEDICARE: DR. JOSEPH PAUL FIACABLE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	IN01020102	IN
2	2084P0800X	Psychiatry Physician	01020102	IN

General Provider Information

NPI Number	:	1447303326
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH PAUL FIACABLE M.D.

Provider Business Mailing Address
First Line	:	2426 LAKE AVE
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46805-5406
Country	:	US
Telephone Number	:	260-423-3304
Fax Number	:	260-426-4284

Provider Business Practice Location Address
First Line	:	2426 LAKE AVE
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46805-5406
Country	:	US
Telephone Number	:	260-423-3304
Fax Number	:	260-426-4284

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/22/2007
Last Update Date	:	01/04/2026

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