Organization
INNOVATIVE HEALTH SERVICES LLC
Active
Parent organization
INNOVATIVE HEALTH SERVCIES LLC
Other names
Innovative Medical Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
INNOVATIVE HEALTH SERVCIES LLC
Authorized official
DR. JOHN V BARTON MD (DIRECTOR)
(888) 447-2450
Entity
Organization
Contact information
Practice address
1570 LINDBERG DR, STE 12, SLIDELL, LA 70458-8058
(985) 649-7070
Mailing address
DEPT 960375, OKLAHOMA CITY, OK 73196-0001
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
LA
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1017621
—
LA
01
—
DR4884
RAILROAD MEDICARE
LA
Enumeration date
07/30/2010
Last updated
05/31/2012
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