Fairbanks, John H
Fairbanks, John H is an sole proprietor health care provider with primary practice located at 107 Front St Suite 2134, Vidalia LA 71373-2836. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Orthopaedic Surgery is his primary health care specialty. Fairbanks, John H can be contacted via phone (318) 336-2212.Contact Information
Primary practice address
107 Front St Suite 2134
Vidalia LA 71373-2836
Phone: (318) 336-2212
Fax: (318) 336-6067
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 15703 | Mississippi |
| Allopathic & Osteopathic Physicians / Sports Medicine | 207XX0005X | MD.017268 | Louisiana |
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | MD017268 | Louisiana |
Profile Details
| NPI number | 1669491288 |
|---|---|
| LBN Legal business name | Fairbanks, John H |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 18th, 2006 |
| Last updated | Jul 20th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669491288 | NPPES |
| Mississippi | MEDICAID | 00119142 | |
| Mississippi | MEDICAID | 1384101 |
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