Individual
MRS. ELIZABETH HEATHER FAIRBANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3786 CENTRAL PIKE, # 130, HERMITAGE, TN 37076-3497
(615) 883-2200
(615) 883-1104
Mailing address
3786 CENTRAL PIKE, # 130, HERMITAGE, TN 37076-3497
(615) 883-2200
(615) 883-1104
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
034602
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3898721
—
TN
Enumeration date
01/12/2006
Last updated
03/08/2010
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