Provider Demographics
NPI:1861509747
Name:FAIRFIELD MEDICAL GROUP, INC.
Entity Type:Organization
Organization Name:FAIRFIELD MEDICAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:P
Authorized Official - Last Name:SIMCOE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-829-2614
Mailing Address - Street 1:741 WESSEL DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-3611
Mailing Address - Country:US
Mailing Address - Phone:513-829-2614
Mailing Address - Fax:513-829-0177
Practice Address - Street 1:741 WESSEL DR
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-3611
Practice Address - Country:US
Practice Address - Phone:513-829-2614
Practice Address - Fax:513-829-0177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty