# IKEMD, A PROFESSIONAL MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124385760
- **Authorized official:** DR. PAUL A.R. IKEMIRE M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (504) 717-3050

## Contact information

- **Practice address:** 2547 PALMYRA ST, SUITE 101, NEW ORLEANS, LA 70119-6427
- **Practice address phone:** (504) 754-2388
- **Practice address fax:** (504) 754-7669
- **Mailing address:** 2547 PALMYRA ST, SUITE 101, NEW ORLEANS, LA 70119-6427
- **Mailing address phone:** (504) 754-2388
- **Mailing address fax:** (504) 754-7669

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251S00000X | Community/Behavioral Health Agency | MD.205087 | LA | — |
| 261QC1500X | Community Health Clinic/Center | MD.205087 | LA | Yes |
| 261QP2300X | Primary Care Clinic/Center | MD.205087 | LA | — |

## Other

- **Enumeration date:** 04/20/2012
- **Last updated:** 04/20/2012