Individual
DR. STACY FAIRBANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
51301
CO
207L00000X
Anesthesiology Physician
Primary
73410
WI
207L00000X
Anesthesiology Physician
MD151109
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100099772
—
WI
05
—
1730389644
—
WI
05
—
39889041
—
CO
Enumeration date
07/19/2007
Last updated
06/03/2026
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