Fairhurst Dermatology in Goodlettsville - Specialist
Fairhurst Dermatology - NPI 1114010741
Fairhurst Dermatology is a Specialist in Goodlettsville, Tennessee. Fairhurst Dermatology practices all healthcare services and medical treatments related to Specialist. The NPI Number for Fairhurst Dermatology is 1114010741. The last update date is 2013-03-19.
Fairhurst Dermatology's current location address is 3040 Business Park Cir, Goodlettsville, Tennessee. You can contact this provider via phone number 6158701404 and fax number 6158701454. The mailing address for Fairhurst Dermatology is 3040 Business Park Cir, Goodlettsville, Tennessee. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Fairhurst Dermatology |
|---|---|
| Address | 3040 Business Park Cir, Goodlettsville, Tennessee |
| Phone Number | 6158701404 |
| Fax Number | 6158701454 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT/ |
|---|---|
| Authorized Official Name | Fairhurst Victor Mark |
| Credentials | MD |
| Telephone Number | 6158701404 |
NPI Number Detail
| NPI Number | 1114010741 |
|---|---|
| Provider Enumeration Date | 2006-10-02 |
| Last Updated Date | 2013-03-19 |
Provider Mailing Address Detail
| Address | 3040 Business Park Cir |
|---|---|
| City | Goodlettsville |
| State | Tennessee (TN) |
| Post Code | 370723594 |
| Phone Number | 6158701404 |
| Fax Number | 6158701454 |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
| Licence No | 36190 |
|
Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 4053381 | TN | TENNCARE SELECT PROV NUMB | |
| P00010292 | TN | RAILROAD MEDICAID PROV NU | |
| 4053381 | TN | BCBST PROVIDER NUMBER | |
| F27966 | TN | HEALTHSPRING PROVIDER NUM | |
| 4281928 | TN | AETNA PROVIDER NUMBER | |
| 50554854 | TN | TRICARE PROVIDER NUMBER | |
| 3714159 | TN | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Fairhurst Dermatology by the Centers for Medicare & Medicaid Services?
The Fairhurst Dermatology has been assigned the NPI (National Provider Identifier) 1114010741. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical address where Fairhurst Dermatology is geographically located?
The Fairhurst Dermatology is physically situated at the following location: 3040 Business Park Cir, Goodlettsville, TN, 370723594.
What is Fairhurst Dermatology's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Fairhurst Dermatology's specialized field of practice is Specialist, and the corresponding taxonomy code that categorizes this area of specialization is 174400000X.
On what date did the Fairhurst Dermatology receive the assignment of its 1114010741 from the Centers for Medicare & Medicaid Services?
The Fairhurst Dermatology was issued its 1114010741 by the Centers for Medicare & Medicaid Services on 2006-10-02.
When was the information related to Fairhurst Dermatology most recently updated or refreshed?
The details pertaining to the Fairhurst Dermatology, including its address, specialty, and other relevant information, were last updated or refreshed on 2013-03-19.