# FAIRMONT PHYSICIANS, INC

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

## Provider details

- **NPI number:** 1639463722
- **Authorized official:** ROBERT BURKLEY (DIRECTOR)
- **Authorized official phone:** (304) 367-7315

## Contact information

- **Practice address:** 51 SOUTHLAND DR, SUITE 1200, FAIRMONT, WV 26554-2244
- **Practice address phone:** (304) 363-2018
- **Practice address fax:** (304) 333-2456
- **Mailing address:** PO BOX 2990, FAIRMONT, WV 26555-2990
- **Mailing address phone:** (304) 367-0387
- **Mailing address fax:** (304) 367-9470

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 06/06/2011
- **Last updated:** 06/06/2011