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FAIRHURST DERMATOLOGY
NPI 1114010741
Specialist in Goodlettsville, TN

Active since October 02, 2006
3040 BUSINESS PARK CIR, GOODLETTSVILLE, TN 37072(615) 870-1404(615) 870-1454 Get Directions Write a Review

NPPES record last updated: March 19, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Fairhurst Dermatology NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FAIRHURST DERMATOLOGY (NPI 1114010741) is a healthcare organization registered as a specialist in Goodlettsville, Tennessee and active in the NPI registry since October 2006. The organization lists Mark Victor Fairhurst, President/owner, as its authorized official.

NPPES Registry Identity

NPI1114010741
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameFAIRHURST DERMATOLOGY
Location Address3040 BUSINESS PARK CIRGoodlettsville, TN 37072-3594
Mailing Address3040 Business Park CirGoodlettsville, TN 37072-3594 · (615) 870-1404 · Fax (615) 870-1454
Phone(615) 870-1404
Fax(615) 870-1454
Organization SubpartNo
Authorized OfficialMark Victor FairhurstPresident/owner · (615) 870-1404
Enumeration DateOctober 2, 2006
Last NPPES UpdateMarch 19, 2013
✔ NPI 1114010741 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in TN · 36190
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
3040 BUSINESS PARK CIR, Goodlettsville, TN 37072
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Other Identifiers 9

Medicare ID-Type Unspecified3714159TN · Medicare Provider Number
Medicaid3714159TN
Other4053381TN · Tenncare Select Prov Numb
Other4281928TN · Aetna Provider Number
Other4053381TN · Bcbst Provider Number
OtherF27966TN · Healthspring Provider Num
Medicare UPINF27966TN
Other50554854TN · Tricare Provider Number
OtherP00010292TN · Railroad Medicaid Prov Nu

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fairhurst Dermatology's NPI number?

The NPI number for Fairhurst Dermatology is 1114010741. It was assigned to this organization in the NPPES registry on October 2, 2006.

Where is Fairhurst Dermatology located?

Fairhurst Dermatology is located at 3040 Business Park Cir, Goodlettsville, TN 37072. The listed phone number is (615) 870-1404.

What is Fairhurst Dermatology's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Fairhurst Dermatology was last updated on March 19, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.