Organization
AVALA PHYSICIAN NETWORK, LLC
Active
Parent organization
FAIRWAY MEDICAL CENTER, LLC
Other names
Avala
Organization subpart
Yes
Provider details
NPI number
Legal business name
FAIRWAY MEDICAL CENTER, LLC
Authorized official
CHRISTOPHER DANIEL (PRESIDENT)
(985) 809-9888
Entity
Organization
Contact information
Practice address
19065 DR JOHN LAMBERT DR STE 2000A, HAMMOND, LA 70403-0997
(985) 892-8934
(985) 801-3099
Mailing address
19065 DR JOHN LAMBERT DR STE 2000, HAMMOND, LA 70403-1027
(225) 610-7054
(985) 801-3099
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Enumeration date
02/25/2021
Last updated
02/25/2021
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