John L Fambrough, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

011330 Issued in LA

Practice address

15781 Professional PLZ
Hammond, LA 70403-1452

Phone

(985) 542-1533

Fax

(985) 542-6713

NPI assigned

Jun 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266969600000",
    "number": "1659314623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15781 PROFESSIONAL PLZ",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704031452",
            "telephone_number": "985-542-1533",
            "fax_number": "985-542-6713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15781 PROFESSIONAL PLZ",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704031452",
            "telephone_number": "985-542-1533",
            "fax_number": "985-542-6713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAMBROUGH",
        "first_name": "JOHN",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2010-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "LA",
            "license": "011330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "51992C490",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1172561",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tonya Doan Ezell, SLP
• Michael Edward Fahr, M.D.
• Sadie Marelle Failla, BS
• Jessica Granier Fajoni
• Michael L Fajoni, M.D.
• Family Chiropractic Center
• Family Health Care and Wellness Center
• Family Health Centers LLC
• Family Health Centers LLC
• Family Medicine Physicians, L.L.C.

• Specialist in Hammond, LA
• Providers in Hammond, LA by specialty
• Specialist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2010; 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.