Fambrough, John L
Fambrough, John L is an individual health care provider with primary practice located at 15781 Professional Plz , Hammond LA 70403-1452. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Fambrough, John L can be contacted via phone (985) 542-1533.Contact Information
Primary practice address
15781 Professional Plz
Hammond LA 70403-1452
Phone: (985) 542-1533
Fax: (985) 542-6713
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 011330 | Louisiana |
Profile Details
| NPI number | 1659314623 |
|---|---|
| LBN Legal business name | Fambrough, John L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 14th, 2006 |
| Last updated | Feb 24th, 2010 - about 15 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 | 1659314623 | NPPES |
| Louisiana | Other | 51992C490 | MEDICARE PTAN |
| Louisiana | MEDICAID | 1172561 | MEDICARE PTAN |
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