Fazenbaker, Stacey B.

Fazenbaker, Stacey B. is an individual health care provider with primary practice located at 3333 Frederica St Ste 5 , Owensboro KY 42301-6085. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Fazenbaker, Stacey B. can be contacted via phone (270) 297-9075.

Contact Information

Primary practice address
3333 Frederica St Ste 5 Owensboro KY 42301-6085
Phone: (270) 297-9075
Fax: (270) 297-9077
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 35999 Kentucky

Profile Details

NPI number 1487615787
LBN Legal business name Fazenbaker, Stacey B.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2006
Last updated Mar 3rd, 2022 - about 2 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 1487615787 NPPES
Kentucky MEDICAID 6402415100
Kentucky Other 7570
Kentucky Other 35999
Kentucky Other 000000811728

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