Individual
BURT I FAIBISOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
810 AINSWORTH DR, PRESCOTT, AZ 86301-1612
(928) 515-1155
(928) 460-5158
Mailing address
1354 AUTUMN WALK, PRESCOTT, AZ 86305-2112
(602) 476-4074
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
13213
AZ
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
13213
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
226672
—
AZ
Enumeration date
06/06/2006
Last updated
11/10/2025
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