Individual
VIVIAN C FAIRCLOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1695 ROOSEVELT AVE STE B, YORK, PA 17408-8521
(717) 851-5503
(717) 798-3510
Mailing address
3421 CONCORD RD, YORK, PA 17402-9001
(717) 851-5503
(717) 851-5507
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
BF7510212
PA
2084N0400X
Neurology Physician
Primary
MD073033L
PA
2084N0400X
Neurology Physician
ME128751
FL
Other
Enumeration date
05/13/2006
Last updated
03/01/2021
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