Individual
JOSHUA FAIRBANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3909 NEW VISION DR, FORT WAYNE, IN 46845-1725
(260) 469-6610
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10002379A
IN
363A00000X
Physician Assistant
—
—
Other
Enumeration date
07/07/2017
Last updated
10/14/2022
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