Fasnacht, Elbert A

Fasnacht, Elbert A is an individual health care provider with primary practice located at 721 S Lewis Ln , Carbondale IL 62901-3344. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Fasnacht, Elbert A can be contacted via phone (618) 457-4999.

Contact Information

Primary practice address
721 S Lewis Ln Carbondale IL 62901-3344
Phone: (618) 457-4999
Fax: (618) 457-5099
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036075250 Illinois

Profile Details

NPI number 1790834828
LBN Legal business name Fasnacht, Elbert A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 9th, 2007
Last updated Sep 10th, 2009 - about 15 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 1790834828 NPPES
Illinois Other 110019903 RAILROAD MEDICARE
Illinois Other 036075250 RAILROAD MEDICARE

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