Provider Demographics
NPI:1386801918
Name:FAIRCHILD, CHAD DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:CHAD
Middle Name:DAVID
Last Name:FAIRCHILD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4150 NELSON RD # A
Mailing Address - Street 2:SUITE 4
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70605-4148
Mailing Address - Country:US
Mailing Address - Phone:337-478-2124
Mailing Address - Fax:337-477-7616
Practice Address - Street 1:4150 NELSON RD # A
Practice Address - Street 2:SUITE 4
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-4148
Practice Address - Country:US
Practice Address - Phone:337-478-2124
Practice Address - Fax:337-477-7616
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-21
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10037454207L00000X
LAMD.206292207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology