Individual
NICHOLAS JOHN FAYARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2525 TELEPHONE RD, PASCAGOULA, MS 39567-3202
(228) 762-4483
(228) 762-3147
Mailing address
2101 HIGHWAY 90, GAUTIER, MS 39553-5340
(228) 497-7576
(228) 497-8869
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
22051
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09129044
—
MS
Enumeration date
07/11/2007
Last updated
03/02/2022
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