Mr. Jeffrey J. Fanning
MD | Pediatric Critical Care Medicine | Male
Mr. Jeffrey J. Fanning, MD is a Dallas, Texas based Pediatric doctor with medical specialization in
Pediatric Critical Care Medicine.
Current practice location of Mr. Jeffrey J. Fanning is
7777 Forest Ln Ste D569, Dallas, Texas - 75230-6903. He can be contacted on phone at
972-566-8340 and fax number 972-566-8338.
Mr. Jeffrey J. Fanning is a sole proprietor of his business.
NPI number (Unique professional ID) for Mr. Jeffrey J. Fanning is
1962442087 which was assigned by NPPES on 07 Jun, 2006 and it was last updated on 09 Mar, 2020.
Mr. Jeffrey J. Fanning license number is
N1317 for Pediatrics Pediatric Critical Care Medicine (2080P0203X) in Texas.
Mr. Jeffrey J. Fanning is expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists.
Complete Profile:
Mr. Jeffrey J. Fanning basic information including his official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Pediatric Critical Care Medicine |
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| Provider Name : | Mr. Jeffrey J. Fanning |
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| Credential : | MD |
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| Gender : | Male |
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Business Address:
Mr. Jeffrey J. Fanning address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 7777 Forest Ln Ste D569
Dallas, TX, 75230-6903
United States |
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| Phone Number : | 972-566-8340 |
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| Fax Number : | 972-566-8338 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1962442087 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 07 Jun, 2006 |
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| Last Updated On : | 09 Mar, 2020 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Mr. Jeffrey J. Fanning are as mentioned. Primary taxonomy code for Mr. Jeffrey J. Fanning, MD is
2080P0203X (Pediatrics Pediatric Critical Care Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
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| 2080P0203X | Pediatrics Pediatric Critical Care Medicine | No | 48843 | WI |
| 2080P0203X | Pediatrics Pediatric Critical Care Medicine | Yes | N1317 | TX |
Legacy Identifiers:
Other legacy medical identifiers of Mr. Jeffrey J. Fanning such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
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| 34843900 | MEDICAID | WI | |
| 204410903 | MEDICAID | TX | |
Other Practice Locations:
| Practice Address | City, State | Phone Number |
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835 S VAN BUREN ST,
GREEN BAY, WI, 54301-3526
United States | GREEN BAY, WI | 920-496-4700 |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | Po Box 515055
Dallas, TX, 75251-5055
United States |
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| Phone Number : | 972-566-8340 |
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| Fax Number : | 972-566-8338 |
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Business Location:
Patients can refer following map for directions to
Mr. Jeffrey J. Fanning practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.