INGRAM MEDICAL CLINIC-CARDIOVASCULAR DIVISION LLC NPI 1336139799

NPI Information

NPI: 1336139799
Provider Name: INGRAM MEDICAL CLINIC-CARDIOVASCULAR DIVISION, LLC
Classification: Internal Medicine - 207RC0000X
Entity Type: Organization

Specialization: Cardiovascular Disease

CLIA Number: 19D0992532

Address:
501 KEYSER AVE
NATCHITOCHES, LA
ZIP 71457
Phone: (318) 214-4550
Get Directions

INGRAM MEDICAL CLINIC-CARDIOVASCULAR DIVISION, LLC is a cardiovascular disease internal medicine in Natchitoches, LA. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. INGRAM MEDICAL CLINIC-CARDIOVASCULAR DIVISION, LLC NPI is 1336139799. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

501 KEYSER AVE
NATCHITOCHES, LA
ZIP 71457-018
Phone: (318) 214-4550
Fax: (318) 354-2468

The provider's authorized official is Christopher L Ingram .
The authorized official title is Owner and has the following contact phone number (318) 354-0552.

The CLIA number assigned to this NPI record is 19D0992532 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/26/2005 and was last updated on 7/21/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RC0000X	Internal Medicine	Cardiovascular Disease		LOUISIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1993450	MEDICAID	LOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »