Organization
NORTHSHORE INTERVENTIONAL PAIN MANAGEMENT, APMC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAULETTE WATTS (BUSINESS MANAGER)
(985) 809-1997
Entity
Organization
Contact information
Practice address
7015 HIGHWAY 190 EAST SERVICE RD, STE. 101, COVINGTON, LA 70433-4960
(985) 809-1997
(985) 809-1664
Mailing address
7015 HIGHWAY 190 EAST SERVICE RD, STE. 101, COVINGTON, LA 70433-4960
(985) 809-1997
(985) 809-1664
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
174463900
OFFICE OF WORKERS COMP
LA
01
—
DA3921
RAILROAD MEDICARE
LA
Enumeration date
06/22/2006
Last updated
03/10/2015
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