Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 35-056645 | OH |
N | 207XS0106X | Orthopaedic Hand Surgeon | 35-056645 | OH |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 35-056645 | OH |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 35-056645 | OH |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 35-056645 | OH |
N | 207XX0801X | Orthopaedic Trauma Surgeon | 35-056645 | OH |
NPI | 1073560447 |
---|---|
Provider Name | Dr. Frank J Fasano JR. |
First Address | Miamisburg, OH 45342-3674 |
Second Address | Miamisburg, OH 45342-3674 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2006 |
Last Update Date | 14/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0699150 | (05) | OH |
A17387 | (02) | OH |