Organization
IMG PHYSICIANS,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONIQUE ROMERO (REVENUE TEAM LEAD)
(337) 408-0797
Entity
Organization
Contact information
Practice address
56 STARBRUSH CIR, COVINGTON, LA 70433-7208
(337) 408-0797
(985) 871-0529
Mailing address
1375 CORPORATE SQUARE DR, SLIDELL, LA 70458-3147
(337) 408-0797
(985) 643-9808
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RI0200X
Infectious Disease Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03676839
—
MS
05
—
1448125
—
LA
Enumeration date
06/04/2006
Last updated
01/21/2022
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