Provider Demographics
NPI:1588452478
Name:IMLER, JEFFERY ALLEN
Entity type:Individual
Prefix:
First Name:JEFFERY
Middle Name:ALLEN
Last Name:IMLER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 459
Mailing Address - Street 2:
Mailing Address - City:PRAIRIEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70769-0459
Mailing Address - Country:US
Mailing Address - Phone:225-239-2301
Mailing Address - Fax:225-341-8526
Practice Address - Street 1:PO BOX 459
Practice Address - Street 2:
Practice Address - City:PRAIRIEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70769-0459
Practice Address - Country:US
Practice Address - Phone:225-239-2301
Practice Address - Fax:225-341-8526
Is Sole Proprietor?:No
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic