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Individual

DR. GEORGE E FAHY III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2004 MEDICAL CENTER DR, BAY MINETTE, AL 36507-4163
(251) 937-2380
(251) 937-7841
Mailing address
2004 MEDICAL CENTER DR, BAY MINETTE, AL 36507-4163
(251) 937-2380
(251) 937-7841

Taxonomy

Speciality
Code
Description
License number
State
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
24699
AL
207VG0400X
Gynecology Physician
24689
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009994760
AL
01
160059682
RAILROAD RETIRE PROV NUMB
01
51510969
BCBS PROVIDER NUMBER
AL
01
630438739007
CHAMPUS PROVIDER NUMBER
Enumeration date
07/26/2006
Last updated
06/10/2019
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