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Fairhurst Dermatology
Specialist in Goodlettsville, Tennessee
NPI 1114010741

Fairhurst Dermatology is a Specialist based in Goodlettsville, TN. Fairhurst Dermatology practices in Goodlettsville, TN. The NPI Number for Fairhurst Dermatology is 1114010741 and holds a License No. 36190 (Tennessee).

The current practice location address for Fairhurst Dermatology is 3040 Business Park Cir, Goodlettsville, TN and can be reached out via phone at 615-870-1404 and via fax at 615-870-1454.

Location: 3040 Business Park Cir, Goodlettsville, TN, 37072-3594
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1114010741
Provider Name
Fairhurst Dermatology
Credential
Provider Entity Type
Organization
Address
3040 Business Park Cir, Goodlettsville, TN, 37072-3594
Phone Number
615-870-1404
Fax Number
615-870-1454
Provider Enumeration Date
10/02/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
4053381 01 TN TENNCARE SELECT PROV NUMB
P00010292 01 TN RAILROAD MEDICAID PROV NU
4053381 01 TN BCBST PROVIDER NUMBER
F27966 01 TN HEALTHSPRING PROVIDER NUM
4281928 01 TN AETNA PROVIDER NUMBER
50554854 01 TN TRICARE PROVIDER NUMBER
3714159 05 TN
institution
Provider Business Practice Location Address Details
Address
3040 Business Park Cir
City
Goodlettsville
State
Tennessee
Zip
37072-3594
Phone Number
615-870-1404
Fax Number
615-870-1454
person
Provider Business Mailing Address Details
Address
3040 Business Park Cir
City
Goodlettsville
State
Tennessee
Zip
37072-3594
Phone Number
615-870-1404
Fax Number
615-870-1454
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
36190 (Tennessee)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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