DR. JONATHAN T FAIRBANK MD NPI 1184645814

NPI Information

NPI: 1184645814
Provider Name: DR. JONATHAN T FAIRBANK, MD
Classification: Radiology - 2085N0904X
Entity Type: Individual

Specialization: Nuclear Radiology

Address:
111 COLCHESTER AVE
DEPT. OF RADIOLOGY
BURLINGTON, VT
ZIP 05401
Phone: (802) 847-3592
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DR. Jonathan T Fairbank, MD is a nuclear radiology radiology in Burlington, VT. The provider is a radiologist who is involved in the analysis and imaging of radionuclides and radiolabeled substances in vitro and in vivo for diagnosis and the administration of radionuclides and radiolabeled substances for the treatment of disease. DR. Jonathan T Fairbank, MD NPI is 1184645814. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

111 COLCHESTER AVE
DEPT. OF RADIOLOGY
BURLINGTON, VT
ZIP 05401-473
Phone: (802) 847-3592
Fax: (802) 847-4822

The enumeration date for this NPI number is 7/21/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085N0904X	Radiology	Nuclear Radiology	042-0003761	VERMONT	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	B85600	MEDICARE UPIN	VERMONT
2	4755	MEDICAID	VERMONT
3	FAVT4755	MEDICARE ID-TYPE UNSPECIFIED	VERMONT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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