NPIMap

Organization Active NPI

Gulf South Medical & Surgical Institute, Inc.

  • Specialist
  • Covington, LA
National Provider Identifier
1437320231
Registry record updated Mar 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
207NI0002X Issued in LA
Legal business name
GULF SOUTH MEDICAL & SURGICAL INSTITUTE, INC.
Practice address
600 N Highway 190 Ste 201
Covington, LA 70433-5083
Phone
(985) 892-5497
Fax
(985) 892-9088
NPI assigned
Mar 19, 2008
Organization subpart
Yes
Parent organization
GULF SOUTH MEDICAL & SURGICAL INSTITUTE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 19, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. George Allen Farber Sr., MD
Title
Medical Director/Owner
Phone
(504) 471-3100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 207NI0002X LA Primary

Addresses

Primary practice location

600 N Highway 190 Ste 201
Covington, LA 70433-5083

Mailing address

PO Box 459
Kenner, LA 70063-0459
Phone (504) 471-3100

Other identifiers 1

IdentifierTypeStateIssuer
1114723MedicaidLA

Other names 1

  • Covington Dermatology Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Gulf South Medical Surgical Institute2 organizations share this tax ID, including this one
Part of
Gulf South Medical Surgical Institute

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

600 N Highway 190
Ste 201
Covington, LA 70433
Phone (985) 643-4512

380 Gateway Dr
Ste B
Slidell, LA 70461
Phone (504) 278-2028

888 Terry Pkwy
Ste 207
Terrytown, LA 70056
Phone (504) 394-6564

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205884800000",
    "number": "1437320231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 459",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "700630459",
            "telephone_number": "504-471-3100",
            "fax_number": "504-471-3109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N HIGHWAY 190 STE 201",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704335083",
            "telephone_number": "985-892-5497",
            "fax_number": "985-892-9088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF SOUTH MEDICAL & SURGICAL INSTITUTE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GULF SOUTH MEDICAL & SURGICAL INSTITUTE, INC.",
        "enumeration_date": "2008-03-19",
        "last_updated": "2008-03-19",
        "status": "A",
        "authorized_official_last_name": "FARBER",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR/OWNER",
        "authorized_official_telephone_number": "504-471-3100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "LA",
            "license": "207NI0002X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114723",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Covington Dermatology Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Covington, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.