Individual
DR. JOHN WILLIAM FAIRCLOTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ED.D., SLP-CCC
Contact information
Practice address
2107 LIBERTY ST, CHESAPEAKE, VA 23324-3527
(757) 494-7600
(757) 494-7573
Mailing address
2107 LIBERTY ST, CHESAPEAKE, VA 23324-3527
(757) 494-7600
(757) 494-7573
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202001051
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2202001051
BOARD OF AUDIOLOGY AND SPEECH PATHOLOGY
VA
Enumeration date
02/28/2018
Last updated
02/28/2018
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