MEDICARE: KENNER OUTPATIENT SURGERY CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center	132	LA

General Provider Information

NPI Number	:	1376758771
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KENNER OUTPATIENT SURGERY CENTER

Provider Business Mailing Address
First Line	:	PO BOX 459
Second Line	:
City	:	KENNER
State	:	LA
Zip	:	70063-0459
Country	:	US
Telephone Number	:	504-471-3100
Fax Number	:

Provider Business Practice Location Address
First Line	:	3705 FLORIDA AVE
Second Line	:
City	:	KENNER
State	:	LA
Zip	:	70065-3031
Country	:	US
Telephone Number	:	504-471-3100
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. GEORGE A. FARBER
Credential	:	M.D.
Telephone Number	:	504-471-3100

Provider Enumeration Date	:	05/11/2007
Last Update Date	:	08/22/2020

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Directions to “KENNER OUTPATIENT SURGERY CENTER ” Practice Location

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