Provider Demographics
NPI:1477873057
Name:FAIRFIELD COUNTY GENERAL HEALTH DISTRICT
Entity Type:Organization
Organization Name:FAIRFIELD COUNTY GENERAL HEALTH DISTRICT
Other - Org Name:THE FAIRFIELD DEPARTMENT OF HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HEALTH COMMISSIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:AEBI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:740-652-2827
Mailing Address - Street 1:1550 SHERIDAN DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-1381
Mailing Address - Country:US
Mailing Address - Phone:740-652-2827
Mailing Address - Fax:740-653-6626
Practice Address - Street 1:1550 SHERIDAN DR
Practice Address - Street 2:SUITE 100
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-1381
Practice Address - Country:US
Practice Address - Phone:740-652-2827
Practice Address - Fax:740-653-6626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-07
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHBA2088323207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty