Shan R Fairbanks
Family Doctor Family Doctor - Sports Medicine
118 Broad St
Dublin
, Virginia 24084-3211
Shan R Fairbanks
Family Doctor Family Doctor - Sports Medicine
118 Broad St
Dublin
, Virginia 24084-3211
(540) 224-5684
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About
Features
Specialties
- Family Doctor
- Family Doctor - Sports Medicine
Languages spoken
- English
Location
First Address
- Shan R Fairbanks
- 213 S Jefferson St Ste 625
- Roanoke, VA
- Zip : 24011-1713
- Fax : (540) 224-5684
- Phone : (540) 224-5516
Second Address
- Shan R Fairbanks
- 118 Broad St
- Dublin, VA
- Zip : 24084-3211
- Fax : (540) 674-8670
- Phone : (540) 674-8805
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207Q00000X | Family Doctor | 0102204926 | VA |
| N | 207QS0010X | Family Doctor - Sports Medicine | 0102204926 | VA |
National Provider Identifier
| NPI | 1003202847 |
|---|---|
| Provider Name | Shan R Fairbanks |
| First Address | Roanoke, VA 24011-1713 |
| Second Address | Dublin, VA 24084-3211 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 08/04/2015 |
| Last Update Date | 16/06/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.