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Contact Information

J H FAIRBANKS MD PLLC
107 FRONT ST
SUITE 230
VIDALIA, LA39120
 Phone: 318-336-2212
 Fax: 318-336-6067
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Orthopaedic Surgery

207X00000X 02 Physician/General Surgery
 

Sports Medicine

207XX0005X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for J H FAIRBANKS MD PLLC

NPI Number 1336209550
LBN Legal business name J H FAIRBANKS MD PLLC
Authorized official ANGEL NUGENT - (MANAGER)
Entity Organization
Organization subpart 1 Yes
Enumeration date 12/11/2006
Last updated 07/03/2023 - About 3 years ago
Identifiers
LA License # MD017268
MS License # 15703
LA Medicaid 1384101
MS Medicaid 00119142
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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