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General NPI Number Information
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NPI Number | 1679959282
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Entity Type | Organization
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Legal Business Name | LOUISIANA INTERNAL MEDICINE ASSOCIATES, LLC
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Dates
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Enumeration Date | 08/05/2015
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 13201 HWY 73 SUITE 102
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City | GEISMAR
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State | LA
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Zip | 70734
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Country | US
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Telephone | 225-673-2088
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Fax | 225-673-2080
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Provider Business Mailing Address
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Address Line | 13201 HWY 73 SUITE 102
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City | GEISMAR
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State | LA
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Zip | 70734
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Country | US
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Telephone | 225-673-2088
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Fax | 225-673-2080
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Authorized Official
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Title or Position | CFO
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Name | KENDALL JOHNSON
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Credential |
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Telephone | 225-237-1645
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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