| Doctor Name: | CLIFFORD W FAWCETT |
| NPI Number: | 1184649337 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CNP |
| License Number: | UP004512B |
| Business Practice Address: | 888 Dayton St Suite 200 Yellow Springs, OH - 453871777 |
| Business Phone Number: | 9377677291 |
| Business Fax Number: | 9377671302 |
| Mailing Address: | 888 Dayton St, Suite 200 YELLOW SPRINGS |
| State: | OH |
| Postal Code: | 453871777 |
| Phone Number: | 9377677291 |
| Fax Number: | 9377671302 |
| NPI Enumeration Date: | 07/12/2006 |
| NPI Last Update Date: | 11/13/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | UP004512B |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |