| Fair Medical Clinic Apmc | |
|
615 Bienville St Natchitoches LA 71457-5730 | |
| (318) 352-6800 | |
| (318) 352-6803 |
| Full Name | Fair Medical Clinic Apmc |
|---|---|
| Speciality | Family Medicine |
| Location | 615 Bienville St, Natchitoches, Louisiana |
| Authorized Official Name and Position | Jack David Fair (OWNER/PHYSICIAN) |
| Authorized Official Contact | 3183526800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fair Medical Clinic Apmc 615 Bienville St Natchitoches LA 71457-5730 Ph: (318) 352-6800 | Fair Medical Clinic Apmc 615 Bienville St Natchitoches LA 71457-5730 Ph: (318) 352-6800 |
| NPI Number | 1508182197 |
|---|---|
| Provider Enumeration Date | 04/08/2010 |
| Last Update Date | 04/08/2010 |
| Medicare PECOS PAC ID | 6608900063 |
|---|---|
| Medicare Enrollment ID | O20100820000304 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508182197 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD.202650 (Louisiana) | Primary |
| Provider Name | Jack D Fair |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568673028 PECOS PAC ID: 0042344400 Enrollment ID: I20100820000334 |
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