MEDICARE: OPENSIDED MRI OF NEW ORLEANS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2471M1202X	Magnetic Resonance Imaging Radiologic Technologist

General Provider Information

NPI Number	:	1134133911
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPENSIDED MRI OF NEW ORLEANS

Provider Business Mailing Address
First Line	:	1 GALLERIA BLVD
Second Line	:	STE 715
City	:	METAIRIE
State	:	LA
Zip	:	70001-2082
Country	:	US
Telephone Number	:	504-837-6736
Fax Number	:	504-837-0835

Provider Business Practice Location Address
First Line	:	1 GALLERIA BLVD
Second Line	:	STE 715
City	:	METAIRIE
State	:	LA
Zip	:	70001-2082
Country	:	US
Telephone Number	:	504-837-6736
Fax Number	:	504-837-0835

Authorized Official
Title or Position	:	DIRECTOR OF BILLING
Name	:	MR. BILL DAVIES
Credential	:
Telephone Number	:	706-781-3922

Provider Enumeration Date	:	07/28/2006
Last Update Date	:	08/22/2020

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