Individual
CLIFFORD W FAWCETT III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CNP
Contact information
Practice address
888 DAYTON ST, SUITE 200, YELLOW SPRINGS, OH 45387-1777
(937) 767-7291
(937) 767-1302
Mailing address
888 DAYTON ST, SUITE 200, YELLOW SPRINGS, OH 45387-1777
(937) 767-7291
(937) 767-1302
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP 10074
OH
363LF0000X
Family Nurse Practitioner
UP004512B
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3108872
—
OH
Enumeration date
07/12/2006
Last updated
11/13/2015
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