Dr. Joel K Fairbanks, PH.D.
Psychologist in Pensacola, FL. Individual provider (NPI-1).
NPI number1992883417
StatusActive
Last updated in NPPESDec 2, 2015
Details
- NPI
- 1992883417
- Entity type
- Individual (NPI-1)
- Name
- Dr. Joel K Fairbanks
- Credential
- PH.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Nov 1, 2006
- Last updated
- Dec 2, 2015
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103T00000X | Psychologist | PY0004557 | FL | Yes |
Practice location
8474 University ParkwayPensacola, FL 32514
Phone 850-384-4125
Mailing address
Po Box 18487Pensacola, FL 32523-8487
Phone 850-478-1312 · Fax 850-474-9060
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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