Healthcare Provider Details

I. General information

NPI: 1598791188
Provider Name (Legal Business Name): OGH IMAGING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 10/18/2024
Certification Date: 10/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1341 1-49 S. SERVICE RD
GRAND COTEAU LA
70541
US

IV. Provider business mailing address

PO BOX 437
GRAND COTEAU LA
70541-0437
US

V. Phone/Fax

Practice location:
  • Phone: 337-407-4523
  • Fax: 337-210-3031
Mailing address:
  • Phone: 337-407-4523
  • Fax: 337-261-2697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LESSIE DOUCET
Title or Position: DIRECTOR OF IMAGING
Credential:
Phone: 337-407-4523