# LOUVIERE ENTERPRISES, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mid South Sleep Disorders Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144284662
- **Authorized official:** MRS. KELIA C INGRAM (OWNER PRESIDENT)
- **Authorized official phone:** (731) 664-8874

## Contact information

- **Practice address:** 386 CARRIAGE HOUSE DR STE D, JACKSON, TN 38305
- **Practice address phone:** (731) 664-8874
- **Practice address fax:** (731) 664-8932
- **Mailing address:** 386 CARRIAGE HOUSE DR STE D, JACKSON, TN 38305-2236
- **Mailing address phone:** (731) 664-8874
- **Mailing address fax:** (731) 664-8932

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RS0012X | Sleep Medicine (Internal Medicine) Physician | — | NULL | Yes |
| 207RS0012X | Sleep Medicine (Internal Medicine) Physician | — | — | Yes |
| 2084N0400X | Neurology Physician | — | NULL | — |
| 2084N0400X | Neurology Physician | — | — | — |
| 261QS1200X | Sleep Disorder Diagnostic Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 04/13/2006
- **Last updated:** 09/21/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 4218325 | BCBS TN | — |