Organization
IMPERIAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRIS HICKINGBOTTOM (CEO)
(337) 433-8400
Entity
Organization
Contact information
Practice address
1747 IMPERIAL BLVD, LAKE CHARLES, LA 70605-5362
(337) 433-8400
Mailing address
501 DR MICHAEL DEBAKEY DR, LAKE CHARLES, LA 70601-5724
(337) 433-8400
(337) 312-6708
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Enumeration date
03/12/2013
Last updated
03/12/2013
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