Outpatient Diagnostic Imaging
Clinic/Center, Radiology in Lake Charles, LA. Organization (NPI-2).
NPI number1124292115
StatusActive
Last updated in NPPESApr 21, 2008
Details
- NPI
- 1124292115
- Entity type
- Organization (NPI-2)
- Legal business name
- Outpatient Diagnostic Imaging
- Organization subpart
- No
- Enumeration date
- Apr 21, 2008
- Last updated
- Apr 21, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QR0200X | Clinic/Center, Radiology | 3780 | LA | Yes |
Practice location
3101 Lake StLake Charles, LA 70601-8337
Phone 337-515-2674 · Fax 337-616-8161
Mailing address
Po Box 1943Lake Charles, LA 70602-1943
Phone 337-515-2674 · Fax 337-616-8161
Authorized official
Nedra Annette Carrier
Owner
3375152674
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