Provider Demographics
NPI:1043702632
Name:INTERNAL MEDICINE SPECIALISTS, INC.
Entity Type:Organization
Organization Name:INTERNAL MEDICINE SPECIALISTS, INC.
Other - Org Name:INTERNAL MEDICINE SPECIALISTS DIAGNOSTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COMPLIANCE SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:L
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-648-2542
Mailing Address - Street 1:3525 PRYTANIA ST STE 526
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-8127
Mailing Address - Country:US
Mailing Address - Phone:504-648-2542
Mailing Address - Fax:
Practice Address - Street 1:3525 PRYTANIA ST STE 526
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-8127
Practice Address - Country:US
Practice Address - Phone:504-648-2542
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTERNAL MEDICINE SPECIALISTS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-05-31
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology