Provider Demographics
NPI:1477602811
Name:FAYETTE COUNTY
Entity Type:Organization
Organization Name:FAYETTE COUNTY
Other - Org Name:FAYETTE CO HEALTH DISTRICT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HEALTH COMMISSIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:VANZANT
Authorized Official - Suffix:
Authorized Official - Credentials:DVM
Authorized Official - Phone:740-335-5910
Mailing Address - Street 1:317 S FAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON CH
Mailing Address - State:OH
Mailing Address - Zip Code:43160-2449
Mailing Address - Country:US
Mailing Address - Phone:740-335-5910
Mailing Address - Fax:740-333-3528
Practice Address - Street 1:317 S FAYETTE ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON CH
Practice Address - State:OH
Practice Address - Zip Code:43160-2449
Practice Address - Country:US
Practice Address - Phone:740-335-5910
Practice Address - Fax:740-333-3528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH340042782083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0233036Medicaid
OH0233036Medicaid