Provider Demographics
NPI:1538107255
Name:P. K. FARRIS, M.D. II, INC
Entity Type:Organization
Organization Name:P. K. FARRIS, M.D. II, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:K
Authorized Official - Last Name:FARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-836-2050
Mailing Address - Street 1:701 METAIRIE RD
Mailing Address - Street 2:SUITE 2A-205
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-4050
Mailing Address - Country:US
Mailing Address - Phone:504-836-2050
Mailing Address - Fax:504-836-9795
Practice Address - Street 1:701 METAIRIE RD
Practice Address - Street 2:SUITE 2A-205
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-4050
Practice Address - Country:US
Practice Address - Phone:504-836-2050
Practice Address - Fax:504-836-9795
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA017017174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5CD54Medicare ID - Type UnspecifiedPRACTICE ID