Organization
SBS IOM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LIZETTE MORIN (MDMS NPI COMPLIANCE OFFICE)
(210) 598-2801
Entity
Organization
Contact information
Practice address
320 E NAPOLEON ST #226, SULPHUR, LA 70663-3318
(504) 215-8179
Mailing address
320 E NAPOLEON ST #226, SULPHUR, LA 70663-3318
(504) 215-8179
Taxonomy
Speciality
Code
Description
License number
State
204R00000X
Electrodiagnostic Medicine Physician
—
—
2084N0400X
Neurology Physician
—
—
2084N0600X
Clinical Neurophysiology Physician
Primary
—
—
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
—
—
Other
Enumeration date
05/24/2018
Last updated
07/18/2018
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