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Organization

IPH, SLIDEL LLC

Active
Parent organization
IPH HOLDINGS, LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
IPH HOLDINGS, LLC
Authorized official
MARIE J WILLIAMS (MEMBER/MEDICAL DIRECTOR)
(985) 641-2202
Entity
Organization

Contact information

Practice address
2364 GAUSE BLVD E STE 101, SLIDELL, LA 70461-4141
(985) 641-2202
(985) 641-2888
Mailing address
501 MARSHALL ST, SUITE 607B, JACKSON, MS 39202-1651
(601) 948-6540
(601) 948-6544

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary

Other

Enumeration date
10/14/2011
Last updated
10/21/2011
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