# DENNIS L. FAST MD INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629335716
- **Authorized official:** DR. DENNIS LEE FAST M.D. (PRESIDENT)
- **Authorized official phone:** (765) 622-0003

## Contact information

- **Practice address:** 350 JH WALKER DR, SUITE 110, PENDLETON, IN 46064-8750
- **Practice address phone:** (765) 622-0003
- **Practice address fax:** (765) 778-7535
- **Mailing address:** 350 JH WALKER DR, SUITE 110, PENDLETON, IN 46064-8750
- **Mailing address phone:** (765) 622-0003
- **Mailing address fax:** (765) 778-7535

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 01028579A | IN | Yes |

## Other

- **Enumeration date:** 04/13/2012
- **Last updated:** 04/13/2012