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General NPI Number Information
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NPI Number | 1073790689
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Entity Type | Organization
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Legal Business Name | INTERNAL MEDICINE ASSOCIATES
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Dates
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Enumeration Date | 01/25/2008
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Last Update Date | 08/11/2011
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Provider Practice Location Address
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Address Line | 201 4TH ST # 30129
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City | ALEXANDRIA
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State | LA
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Zip | 71301-8421
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Country | US
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Telephone | 318-448-1249
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Fax | 318-448-5322
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Provider Business Mailing Address
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Address Line | 201 4TH ST STE 5A
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City | ALEXANDRIA
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State | LA
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Zip | 71301-8421
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Country | US
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Telephone | 318-448-1249
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Fax | 318-448-5322
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MICHELLE A BRYANT
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Credential |
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Telephone | 318-448-1249
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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