NPI Code Details Logo

NPI 1821543166

NPI 1821543166 : ANTHONY DEAN FATZINGER JR. PSYD : FORT BRAGG, NC

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1821543166
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    ANTHONY DEAN FATZINGER JR. PSYD
-----------------------------------------------------
    Gender               |    Male 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    08/16/2016
-----------------------------------------------------
    Last Update Date     |    07/09/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    2817 ROCK MERRITT AVE WOMACK ARMY MEDICAL CENTER 
-----------------------------------------------------
    City                 |    FORT BRAGG
-----------------------------------------------------
    State                |    NC
-----------------------------------------------------
    Zip                  |    28310-4504
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    910-907-8922
-----------------------------------------------------
    Fax                  |    910-907-6069
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    2817 ROCK MERRITT AVE WOMACK ARMY MEDICAL CENTER 
-----------------------------------------------------
    City                 |    FORT BRAGG
-----------------------------------------------------
    State                |    NC
-----------------------------------------------------
    Zip                  |    28310-4504
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    910-907-8922
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    103TC0700X
-----------------------------------------------------
    Taxonomy Name        |    Clinical Psychologist
-----------------------------------------------------
    License Number       |    664
-----------------------------------------------------
    License Number State |    WY
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.