Organization
IHAB JOHN IBRAHIM MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IHAB JOHN IBRAHIM MD (SOLE OWNER)
(318) 572-2067
Entity
Organization
Contact information
Practice address
672 BERT KOUNS INDUSTRIAL LOOP, SHREVEPORT, LA 71118-5701
(318) 572-2067
(318) 572-2067
Mailing address
635 SUMMERVILLE DR, SHREVEPORT, LA 71115-3865
(318) 572-2067
(877) 991-8458
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD.14699R
LA
208100000X
Physical Medicine & Rehabilitation Physician
MD.14699R
LA
208VP0014X
Interventional Pain Medicine Physician
Primary
MD.14699R
LA
Other
Enumeration date
01/22/2018
Last updated
06/16/2018
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