Organization
IMPERIAL HEALTH LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRIS HICKINGBOTTOM (CEO)
(337) 433-8400
Entity
Organization
Contact information
Practice address
1636 ELTON RD, SUITE 202, JENNINGS, LA 70546-3648
(337) 436-3813
Mailing address
501 DR MICHAEL DEBAKEY DR, LAKE CHARLES, LA 70601-5724
(337) 433-8400
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Enumeration date
10/18/2012
Last updated
04/15/2013
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