Provider Demographics
NPI:1427397793
Name:INTEGRATED PAIN AND NEUROSCIENCE
Entity Type:Organization
Organization Name:INTEGRATED PAIN AND NEUROSCIENCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CARISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:COAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-300-9020
Mailing Address - Street 1:2801 NAPOLEON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-6915
Mailing Address - Country:US
Mailing Address - Phone:504-300-9020
Mailing Address - Fax:504-300-9021
Practice Address - Street 1:2801 NAPOLEON AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-6915
Practice Address - Country:US
Practice Address - Phone:504-300-9020
Practice Address - Fax:504-300-9021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-06
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2443925Medicaid
LA276927Medicare PIN