| Imperial Health LLP | |
|
200 W 5th St Deridder LA 70634-4856 | |
| (337) 202-7850 | |
| Not Available |
| Full Name | Imperial Health LLP |
|---|---|
| Speciality | Family Medicine |
| Location | 200 W 5th St, Deridder, Louisiana |
| Authorized Official Name and Position | Nikki Lyn Dugas (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 3373128528 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Imperial Health LLP 501 Dr Michael Debakey Dr Lake Charles LA 70601-5724 | Imperial Health LLP 200 W 5th St Deridder LA 70634-4856 Ph: (337) 202-7850 |
| NPI Number | 1053929166 |
|---|---|
| Provider Enumeration Date | 07/15/2020 |
| Last Update Date | 07/15/2020 |
| Certification Date | 07/15/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053929166 | NPI | - | NPPES |
| 1016314 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (NU) | Primary |
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