Individual
DR. JOEL K FAIRBANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
8474 UNIVERSITY PARKWAY, PENSACOLA, FL 32514
(850) 384-4125
Mailing address
PO BOX 18487, PENSACOLA, FL 32523-8487
(850) 478-1312
(850) 474-9060
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY0004557
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104720
VALUE OPTIONS
FL
01
—
73807
BLUE CROSS BLUE SHIELD
FL
Enumeration date
11/01/2006
Last updated
12/02/2015
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