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General NPI Number Information
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NPI Number | 1396740544
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Entity Type | Individual
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Provider Name | PATRICK J. FALLON M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/15/2005
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Last Update Date | 10/07/2011
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Provider Practice Location Address
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Address Line | 690 MINOT AVE STE 1
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City | AUBURN
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State | ME
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Zip | 04210-3922
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Country | US
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Telephone | 207-783-1328
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Fax | 207-795-0260
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Provider Business Mailing Address
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Address Line | 690 MINOT AVE STE 1
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City | AUBURN
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State | ME
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Zip | 04210-3922
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Country | US
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Telephone | 207-783-1328
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Fax | 207-795-0260
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 013805
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License Number State | ME
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