Healthcare Provider Details

I. General information

NPI: 1609179852
Provider Name (Legal Business Name): DIGITAL IMAGING SERVICES OF LOUISIANA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2010
Last Update Date: 03/01/2023
Certification Date: 03/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2431 S ACADIAN THRUWAY STE 350
BATON ROUGE LA
70808-2374
US

IV. Provider business mailing address

2431 S ACADIAN THRUWAY STE 350
BATON ROUGE LA
70808-2374
US

V. Phone/Fax

Practice location:
  • Phone: 225-926-3391
  • Fax: 225-926-3389
Mailing address:
  • Phone: 225-926-3391
  • Fax: 225-926-3389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247100000X
TaxonomyRadiologic Technologist
License Number
License Number State

VIII. Authorized Official

Name: KELLY ASHWORTH
Title or Position: EXECUTIVE VP
Credential:
Phone: 225-800-4954