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DAVID W FAIRBANKS MD NPI 1700989969


NPI Information

NPI: 1700989969
Provider Name: DAVID W FAIRBANKS, MD
Classification: Family Medicine - 207Q00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
203 HOSPITAL DR
RATON, NM
ZIP 87740
Phone: (575) 445-7720
Get Directions

David W Fairbanks, MD is a family medicine in Raton, NM with 35 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. David W Fairbanks, MD NPI is 1700989969. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF VIRGINIA SCHOOL OF MEDICINE
Graduation Year:1989

The provider's business location address is:

203 HOSPITAL DR
RATON, NM
ZIP 87740-012
Phone: (575) 445-7720
Fax: (575) 445-7737

The NPI 1700989969 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/6/2006 and was last updated on 4/24/2024.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207P00000XEmergency Medicine16369WEST VIRGINIANo
2207P00000XEmergency Medicine6372524-1205UTAHNo
3207P00000XEmergency MedicineMD2022-0625NEW MEXICONo
4207Q00000XFamily Medicine6372524-1205UTAHYes
5207Q00000XFamily MedicineMD2022-0625NEW MEXICONo

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
187155028MEDICAIDNEW MEXICO
23810005265MEDICAIDWEST VIRGINIA

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.