Individual
STACEY B. FAZENBAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M. D.
Contact information
Practice address
444 S MAIN ST, MADISONVILLE, KY 42431-2846
(270) 821-4444
Mailing address
PO BOX 3276, EVANSVILLE, IN 47731-3276
(812) 473-0181
(812) 473-5822
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35999
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000811728
ANTHEM
KY
01
—
35999
KY MEDICAL LICENSE NUMBER
KY
05
—
6402415100
—
KY
01
—
7570
COMMONWEALTH BIOMEDICAL RESEARCH GROUP PTAN
KY
Enumeration date
03/28/2006
Last updated
12/10/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us