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General NPI Number Information
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NPI Number | 1760514962
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Entity Type | Organization
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Legal Business Name | FAIRFIELD OBSTETRICS & GYNECOLOGY, INC
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 07/13/2007
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Provider Practice Location Address
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Address Line | 10 OFFICE PARK DR SUITE A
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City | HAMILTON
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State | OH
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Zip | 45013-1496
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Country | US
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Telephone | 513-867-0999
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Fax | 513-867-1037
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Provider Business Mailing Address
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Address Line | PO BOX 643321
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City | CINCINNATI
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State | OH
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Zip | 45264-0308
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Country | US
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Telephone | 513-867-0999
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Fax | 513-867-1037
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES D REBOULET
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Credential | M.D.
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Telephone | 513-867-0999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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