Provider Demographics
NPI:1689276172
Name:BARRY F FAUST JR MD LLC
Entity Type:Organization
Organization Name:BARRY F FAUST JR MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LECOMPTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-347-1333
Mailing Address - Street 1:5201 WESTBANK EXPY STE 203
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-2901
Mailing Address - Country:US
Mailing Address - Phone:504-347-1333
Mailing Address - Fax:504-347-4755
Practice Address - Street 1:4500 CLEARVIEW PKWY STE 200
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2351
Practice Address - Country:US
Practice Address - Phone:504-350-8700
Practice Address - Fax:504-350-8701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-10
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty