Doctor Name: | DR. KENNETH ERVINE FATKIN |
NPI Number: | 1922238195 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPM |
License Number: | |
Business Practice Address: | 600 Whitney Ranch Dr Suite C13 Henderson, NV - 890142611 |
Business Phone Number: | 7024357987 |
Business Fax Number: | 7024357616 |
Mailing Address: | 600 Whitney Ranch Dr Ste C13, HENDERSON |
State: | NV |
Postal Code: | 890142631 |
Phone Number: | 7024357987 |
Fax Number: | 7024357616 |
NPI Enumeration Date: | 07/21/2009 |
NPI Last Update Date: | 01/25/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |