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NPI Code Detail

MEDICARE: INTEGRATED HEALTH SERVICES INCORPORATED

MEDICARE: INTEGRATED HEALTH SERVICES INCORPORATED
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208D00000XGeneral Practice Physician07043RLA

General Provider Information

NPI Number : 1023260486
Entity Type Code : Organization
Provider Name (Legal Business Name) : INTEGRATED HEALTH SERVICES INCORPORATED
Provider Business Mailing Address
First Line : PO BOX 14282
Second Line :
City : MONROE
State : LA
Zip : 71207-4282
Country : US
Telephone Number : 318-410-1044
Fax Number :
Provider Business Practice Location Address
First Line : 2101 TOWER DR
Second Line :
City : MONROE
State : LA
Zip : 71201-5045
Country : US
Telephone Number : 318-410-1044
Fax Number :
Authorized Official
Title or Position : BUSINESS OWNER
Name : MS. ALICIA TENNANT
Credential :
Telephone Number : 318-410-1044
Provider Enumeration Date : 10/16/2008
Last Update Date : 10/20/2008

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Directions to “INTEGRATED HEALTH SERVICES INCORPORATED ” Practice Location

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