Healthcare Provider Details
I. General information
NPI: 1063471985
Provider Name (Legal Business Name): TIGER VISION, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/20/2006
Last Update Date: 07/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10423 OLD HAMMOND HWY
BATON ROUGE LA
70816-8264
US
IV. Provider business mailing address
10423 OLD HAMMOND HWY
BATON ROUGE LA
70816-8264
US
V. Phone/Fax
- Phone: 225-923-0960
- Fax: 225-923-3736
- Phone: 225-923-0960
- Fax: 225-923-3736
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 173000000X |
| Taxonomy | Legal Medicine |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
SCOTT
NELSON
Title or Position: PARTNER
Credential: M.D.
Phone: 225-923-0960