Organization
RIVERFRONT URGENT CARE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN H FAIRBANKS M.D. (OWNER)
(318) 336-2212
Entity
Organization
Contact information
Practice address
107 FRONT ST, STE 2138, VIDALIA, LA 71373-2836
(318) 336-2219
(318) 336-6067
Mailing address
107 FRONT ST, STE 2138, VIDALIA, LA 71373-2836
(318) 336-2219
(318) 336-6067
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
017268
LA
261QU0200X
Urgent Care Clinic/Center
Primary
017268
LA
Other
Enumeration date
07/05/2016
Last updated
02/07/2017
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