J H FAIRBANKS MD PLLC

VIDALIA, LA
NPI1336209550
Other NameRIVERPARK SPORTS MEDICINE AND PHYSICAL THERAPY
Entity TypeOrganization
Authorized ContactANGEL NICOLE NUGENT
Manager
318-336-2212
Organization Subpart ?Yes
Primary Taxonomy207X00000X Orthopaedic Surgery
(Licence: LA  MD017268)
Additional Taxonomies207X00000X Orthopaedic Surgery
(Licence: MS  15703)
207XX0005X Orthopaedic Surgery, Sports Medicine
(Licence: LA  MD017268)
Enumeration Date2006-12-11
Last Update Date2023-07-03
Business Address
J H FAIRBANKS MD PLLC
107 FRONT ST SUITE 230
VIDALIA, LA 39120
Phone number: 318-336-2212
Mailing Address
J H FAIRBANKS MD PLLC
107 FRONT ST SUITE 230
VIDALIA, LA 39120
Phone number: 318-336-2212
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