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General NPI Number Information
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NPI Number | 1780606004
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Entity Type | Individual
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Provider Name | JEFFREY HASKELL FAIR MD
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Gender | Male
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Dates
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Enumeration Date | 07/24/2006
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 508 JEFFERSON ST
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City | WHITEVILLE
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State | NC
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Zip | 28472-3634
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Country | US
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Telephone | 910-640-2480
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Fax | 910-640-2487
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Provider Business Mailing Address
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Address Line | 1213 OLMSTEAD LN
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City | WILMINGTON
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State | NC
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Zip | 28405-4199
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Country | US
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Telephone | 352-586-1059
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Fax |
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME111974
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | R4219
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 29106
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License Number State | NC
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