Healthcare Provider Details

I. General information

NPI: 1427086362
Provider Name (Legal Business Name): FAIRFIELD HEALTHCARE PROFESSIONALS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 04/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216 TRACE DR
LANCASTER OH
43130-4151
US

IV. Provider business mailing address

PO BOX 2563
LANCASTER OH
43130-5563
US

V. Phone/Fax

Practice location:
  • Phone: 740-654-6300
  • Fax: 740-654-0106
Mailing address:
  • Phone: 740-687-8499
  • Fax: 740-687-8230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: LORI PARRISH
Title or Position: MANAGER
Credential:
Phone: 740-687-8499