Organization
GULF SOUTH MEDICAL & SURGICAL INSTITUTE, INC.
Active
Parent organization
GULF SOUTH MEDICAL & SURGICAL INSTITUTE, INC.
Other names
Covington Dermatology Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
GULF SOUTH MEDICAL & SURGICAL INSTITUTE, INC.
Authorized official
DR. GEORGE ALLEN FARBER SR. MD (MEDICAL DIRECTOR/OWNER)
(504) 471-3100
Entity
Organization
Contact information
Practice address
600 N HIGHWAY 190 STE 201, COVINGTON, LA 70433-5083
(985) 892-5497
(985) 892-9088
Mailing address
PO BOX 459, KENNER, LA 70063-0459
(504) 471-3100
(504) 471-3109
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
207NI0002X
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114723
—
LA
Enumeration date
03/19/2008
Last updated
03/19/2008
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