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General NPI Number Information
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NPI Number | 1861495061
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Entity Type | Individual
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Provider Name | JAMES CLARKE FAIRFIELD MD
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Gender | Male
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Dates
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Enumeration Date | 05/23/2005
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Last Update Date | 11/30/2024
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Provider Practice Location Address
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Address Line | 12 N EVERGREEN DR
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City | LITCHFIELD
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State | ME
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Zip | 04350-3020
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Country | US
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Telephone | 262-456-9720
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Fax |
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Provider Business Mailing Address
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Address Line | 12 N EVERGREEN DR
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City | LITCHFIELD
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State | ME
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Zip | 04350-3020
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Country | US
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Telephone | 262-456-9720
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 60705 - 20
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | MD018193E
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License Number State | PA
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