Provider Demographics
NPI:1427242031
Name:FAIRFIELD MEDICAL ASSOCIATES, PA
Entity type:Organization
Organization Name:FAIRFIELD MEDICAL ASSOCIATES, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HARMON
Authorized Official - Middle Name:F
Authorized Official - Last Name:PATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:803-754-8941
Mailing Address - Street 1:PO BOX 1218
Mailing Address - Street 2:
Mailing Address - City:WINNSBORO
Mailing Address - State:SC
Mailing Address - Zip Code:29180-5218
Mailing Address - Country:US
Mailing Address - Phone:803-635-6461
Mailing Address - Fax:803-635-4200
Practice Address - Street 1:428 2 MCNULTY ROAD
Practice Address - Street 2:
Practice Address - City:BLYTHEWOOD
Practice Address - State:SC
Practice Address - Zip Code:29016
Practice Address - Country:US
Practice Address - Phone:803-754-8941
Practice Address - Fax:803-635-4200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-28
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPA3996Medicaid
SC5787Medicare UPIN
SC5787Medicare PIN