Organization
IHAB JOHN IBRAHIM MD LLC
Active
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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