Organization
IMPERIAL HEALTH, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEITH BROACH (CEO/PRESIDENT)
(337) 433-8400
Entity
Organization
Contact information
Practice address
1322 ELTON RD, SUITE H, JENNINGS, LA 70546-4100
(337) 246-7200
(337) 246-7202
Mailing address
501 DR MICHAEL DEBAKEY DR, LAKE CHARLES, LA 70601-5724
(337) 312-8360
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
LA
207RC0000X
Cardiovascular Disease Physician
—
LA
Other
Enumeration date
08/28/2014
Last updated
08/28/2014
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