| NPI | 1699767509 |
|---|---|
| Former Legal Business Name | FAIRE HARBOUR OB/GYN |
| Entity Type | Organization |
| Authorized Contact | JEFFREY A SIMPSON Owner 860-444-6868 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CT 001146) |
| Enumeration Date | 2005-08-17 |
| Last Update Date | 2010-01-13 |