Healthcare Provider Details

I. General information

NPI: 1932195344
Provider Name (Legal Business Name): JOSEPH M IMSEIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2005
Last Update Date: 08/30/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3909 LAPALCO BLVD SUITE 100
HARVEY LA
70058-2302
US

IV. Provider business mailing address

1101 MEDICAL CENTER BLVD ATTN: HEIDI GWINN
MARRERO LA
70072-3147
US

V. Phone/Fax

Practice location:
  • Phone: 504-349-6900
  • Fax: 504-348-7487
Mailing address:
  • Phone: 504-349-1297
  • Fax: 504-349-1146

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number023705
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: