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NPI Code Detail

MEDICARE: JEFF DAVIS RADIOLOGY ASSOCIATES

MEDICARE: JEFF DAVIS RADIOLOGY ASSOCIATES
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
1174400000XSpecialist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1154383925
Entity Type Code : Organization
Provider Name (Legal Business Name) : JEFF DAVIS RADIOLOGY ASSOCIATES
Provider Business Mailing Address
First Line : PO BOX 1128
Second Line :
City : JENNINGS
State : LA
Zip : 70546-1128
Country : US
Telephone Number : 337-824-4403
Fax Number : 337-824-9731
Provider Business Practice Location Address
First Line : 1634 ELTON RD
Second Line :
City : JENNINGS
State : LA
Zip : 70546-3614
Country : US
Telephone Number : 337-824-4403
Fax Number : 337-824-9731
Authorized Official
Title or Position : OWNER/PARTNER
Name : ALDES J ROZAS III
Credential : M.D.
Telephone Number : 337-824-4403
Provider Enumeration Date : 04/05/2006
Last Update Date : 08/22/2020

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1710972211 — ROBERT C. SCHUMACHER M.D.
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Directions to “JEFF DAVIS RADIOLOGY ASSOCIATES ” Practice Location

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