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Organization
IMPERIAL HEALTH, LLP
Active
Organization
IMPERIAL HEALTH, LLP
Active
Other names
IMPERIAL CALCASIEU MEDICAL GROUP LLP
Organization subpart
No
Provider details
NPI number
Authorized official
TONYA RICHARD (ASSISTANT ADMINISTRATOR)
(337) 312-8291
Entity
Organization
Contact information
Practice address
122 W 4TH ST, DEQUINCY, LA 70633-3508
(337) 401-4920
(337) 313-4237
Mailing address
501 DR MICHAEL DEBAKEY DR, LAKE CHARLES, LA 70601-5724
(337) 433-8400
(337) 312-6708
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
—
—
213E00000X
Podiatrist
—
NULL
213E00000X
Podiatrist
—
—
Other
Enumeration date
08/13/2012
Last updated
01/16/2017
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