Organization
CONSULTANT PATHOLOGY SERVICE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH B FARRIS MD (OWNER/PRESIDENT)
(504) 361-3757
Entity
Organization
Contact information
Practice address
1141 WHITNEY AVE # 3, GRETNA, LA 70056-5011
(504) 361-3757
(504) 361-3132
Mailing address
PO BOX 1907, GRETNA, LA 70054-1907
(504) 361-3757
(504) 361-3132
Taxonomy
Speciality
Code
Description
License number
State
207ND0900X
Dermatopathology Physician
—
—
207ZC0500X
Cytopathology Physician
—
—
207ZD0900X
Dermatopathology (Pathology) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00015045
—
MS
05
—
1131300
—
LA
Enumeration date
09/14/2006
Last updated
11/08/2007
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