Fanning, Jeffrey J.

Fanning, Jeffrey J. is an individual health care provider with primary practice located at 7777 Forest Ln Ste D569 , Dallas TX 75230-6903. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine, which is considered as his primary health care specialty. Fanning, Jeffrey J. can be contacted via phone (972) 566-8340.

Contact Information

Primary practice address
7777 Forest Ln Ste D569 Dallas TX 75230-6903
Phone: (972) 566-8340
Fax: (972) 566-8338
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine 2080P0203X 48843 Wisconsin
Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine 2080P0203X N1317 Texas

Profile Details

NPI number 1962442087
LBN Legal business name Fanning, Jeffrey J.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 7th, 2006
Last updated Mar 9th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962442087 NPPES
Wisconsin MEDICAID 34843900
Wisconsin MEDICAID 204410903

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