Provider Demographics
NPI:1154344513
Name:INGRISH, GEORGE B (MD)
Entity type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:B
Last Name:INGRISH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:201 4TH ST
Mailing Address - Street 2:BOX 30127
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-8421
Mailing Address - Country:US
Mailing Address - Phone:318-449-8600
Mailing Address - Fax:318-449-1461
Practice Address - Street 1:201 FOURTH ST
Practice Address - Street 2:SUITE 4B
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301
Practice Address - Country:US
Practice Address - Phone:318-449-8600
Practice Address - Fax:318-449-1461
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2013-12-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LA021713207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA070013396OtherRAILROAD MEDICARE
LA1480126Medicaid
F62362Medicare UPIN
LA1480126Medicaid