Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | PD142R | LA |
NPI | 1043218449 |
---|---|
Provider Name | Vernon L Garber |
First Address | Lake Charles, LA 70601-5726 |
Second Address | Lake Charles, LA 70601-5726 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2005 |
Last Update Date | 12/05/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U51943 | (02) |