Healthcare Provider Details

I. General information

NPI: 1043255516
Provider Name (Legal Business Name): SITTIG MOBILE X-RAY & CARDIOLOGY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 N AVENUE K
CROWLEY LA
70526-3848
US

IV. Provider business mailing address

711 N AVENUE K
CROWLEY LA
70526-3848
US

V. Phone/Fax

Practice location:
  • Phone: 337-783-4196
  • Fax: 337-783-2400
Mailing address:
  • Phone: 337-783-4196
  • Fax: 337-783-2400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335V00000X
TaxonomyPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
License Number19813
License Number StateLA

VIII. Authorized Official

Name: MS. JOHANNA HABETZ SITTIG
Title or Position: OWNER
Credential: NONE
Phone: 337-783-4196