Provider Demographics
NPI:1346002375
Name:FAIR, STEPHEN GILBERT
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:GILBERT
Last Name:FAIR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5252 ARBORLINE CT
Mailing Address - Street 2:
Mailing Address - City:CANAL WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:43110-8738
Mailing Address - Country:US
Mailing Address - Phone:614-537-3999
Mailing Address - Fax:
Practice Address - Street 1:5252 ARBORLINE CT
Practice Address - Street 2:
Practice Address - City:CANAL WINCHESTER
Practice Address - State:OH
Practice Address - Zip Code:43110-8738
Practice Address - Country:US
Practice Address - Phone:614-537-3999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No347C00000XTransportation ServicesPrivate Vehicle