Organization
FAIRWAY PEDIATRICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATHRYN QUARLS M.D. (ADMINISTRATING PHYSICIAN)
(985) 871-7337
Entity
Organization
Contact information
Practice address
7020 HIGHWAY 190, SUITE C, COVINGTON, LA 70433-4954
(985) 871-7337
(985) 871-7600
Mailing address
7020 HIGHWAY 190, SUITE C, COVINGTON, LA 70433-4954
(985) 871-7337
(985) 871-7600
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1947377
—
LA
Enumeration date
06/18/2006
Last updated
08/22/2020
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