| Kelly Fairbairn, DO | |
|
147 N Brent St, Ventura, CA 93003 | |
| (805) 652-5672 | |
| Not Available |
| Full Name | Kelly Fairbairn |
|---|---|
| Gender | Female |
| Speciality | Thoracic Surgery (cardiothoracic Vascular Surgery) |
| Location | 147 N Brent St, Ventura, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427434174 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208G00000X | Thoracic Surgery (cardiothoracic Vascular Surgery) | 20A15189 (California) | Primary |
| Entity Name | University Surgeons Of Orange A Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1407806904 PECOS PAC ID: 6901705227 Enrollment ID: O20040106000614 |
| Mailing Address | Practice Location Address |
|---|---|
| Kelly Fairbairn, DO 101 The City Dr S, Orange, CA 92868-3201 Ph: () - | Kelly Fairbairn, DO 147 N Brent St, Ventura, CA 93003 Ph: (805) 652-5672 |
Lamar J. Bushnell, M.D. Thoracic Surgery (Cardiothoracic Vascular Surgery) Medicare: Accepting Medicare Assignments Practice Location: 168 N Brent St Ste 508, Ventura, CA 93003 Phone: 805-643-2375 Fax: 805-643-3511 | |
Dominic J. Tedesco, M.D. Thoracic Surgery (Cardiothoracic Vascular Surgery) Medicare: Accepting Medicare Assignments Practice Location: 145 N Brent St, Suite 102, Ventura, CA 93003 Phone: 805-643-2375 Fax: 805-643-3511 |