Healthcare Provider Details

I. General information

NPI: 1912180886
Provider Name (Legal Business Name): FAIRFIELD HEALTHCARE PROFESSIONALS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2007
Last Update Date: 12/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1153 E MAIN ST
LANCASTER OH
43130-4056
US

IV. Provider business mailing address

135 N EWING ST STE 204
LANCASTER OH
43130-3378
US

V. Phone/Fax

Practice location:
  • Phone: 740-687-8990
  • Fax: 740-687-8230
Mailing address:
  • Phone: 740-689-6394
  • Fax: 740-689-6395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: LORI B PARRISH
Title or Position: OFFICE MANAGER
Credential: BS
Phone: 740-687-8095