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NPI Code Detail

MEDICARE: DR. IRIS DENISE FANCHER M.D.

MEDICARE: DR. IRIS DENISE FANCHER M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician00013063AL

General Provider Information

NPI Number : 1366420994
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. IRIS DENISE FANCHER M.D.
Provider Business Mailing Address
First Line : 2201 ARLINGTON AVE
Second Line :
City : BESSEMER
State : AL
Zip : 35020-4221
Country : US
Telephone Number : 205-424-6001
Fax Number : 205-497-9369
Provider Business Practice Location Address
First Line : 2201 ARLINGTON AVE
Second Line :
City : BESSEMER
State : AL
Zip : 35020-4221
Country : US
Telephone Number : 205-424-6001
Fax Number : 205-497-9369
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2006
Last Update Date : 07/09/2007

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