Organization
PLAZA ORTHOPEDIC & SPORTS MEDICINE CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN L FAMBROUGH M.D. (PHYSICIAN PARTNER)
(985) 542-1533
Entity
Organization
Contact information
Practice address
15781 PROFESSIONAL PLZ, HAMMOND, LA 70403-1452
(985) 542-1533
(985) 542-6713
Mailing address
15781 PROFESSIONAL PLZ, HAMMOND, LA 70403-1452
(985) 542-1533
(985) 542-6713
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1949256
—
LA
Enumeration date
06/08/2006
Last updated
02/11/2010
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