Riverpark Sports Medicine And Physical Therapy

LBN: J H Fairbanks Md Pllc
Riverpark Sports Medicine And Physical Therapy is an health care organization with primary practice located at 107 Front St Suite 230, Vidalia LA 39120. The organization 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 the primary health care specialty. J H Fairbanks Md Pllc can be contacted via phone (318) 336-2212, or through Nugent, Angel Nicole via phone (318) 336-2212.

Contact Information

Primary practice address
107 Front St Suite 230 Vidalia LA 39120
Phone: (318) 336-2212
Fax: (318) 336-6067
Website:
Map and Directions
Authorized official contact:
Name: Nugent, Angel Nicole
Phone: (318) 336-2212

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X MD017268 Louisiana
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 15703 Mississippi
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X MD017268 Louisiana

Profile Details

NPI number 1336209550
LBN Legal business name J H Fairbanks Md Pllc
DBA Doing business as Riverpark Sports Medicine And Physical Therapy
Authorized official Nugent, Angel Nicole
Entity Organization
Organization subpart 1 Yes
Enumeration date Dec 11th, 2006
Last updated Jul 3rd, 2023 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336209550 NPPES
Mississippi MEDICAID 00119142
Mississippi MEDICAID 1384101

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