Individual
DR. GERALD L FAIRCHILD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
122 N RICE ST, LOUISA, KY 41230-1242
(606) 638-9006
(606) 638-0899
Mailing address
122 N RICE ST, LOUISA, KY 41230-1242
(606) 638-0089
(606) 638-0899
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7112
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0134596000
—
WV
05
—
60071123
—
KY
Enumeration date
10/27/2006
Last updated
04/01/2008
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