Provider Demographics
NPI:1447303326
Name:FIACABLE, JOSEPH PAUL (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:PAUL
Last Name:FIACABLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2426 LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46805-5406
Mailing Address - Country:US
Mailing Address - Phone:260-423-3304
Mailing Address - Fax:260-426-4284
Practice Address - Street 1:2426 LAKE AVE
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46805-5406
Practice Address - Country:US
Practice Address - Phone:260-423-3304
Practice Address - Fax:260-426-4284
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2015-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ININ010201022084P0800X
IN010201022084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry