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General NPI Number Information
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NPI Number | 1578586798
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Entity Type | Individual
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Provider Name | GEORGE E FAHY III M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 06/10/2019
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Provider Practice Location Address
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Address Line | 2004 MEDICAL CENTER DR
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City | BAY MINETTE
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State | AL
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Zip | 36507-4163
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Country | US
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Telephone | 251-937-2380
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Fax | 251-937-7841
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Provider Business Mailing Address
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Address Line | 2004 MEDICAL CENTER DR
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City | BAY MINETTE
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State | AL
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Zip | 36507-4163
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Country | US
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Telephone | 251-937-2380
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Fax | 251-937-7841
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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 | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 24689
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 207VF0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
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License Number | 24699
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License Number State | AL
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