Healthcare Provider Details

I. General information

NPI: 1073586202
Provider Name (Legal Business Name): CARDIOVASCULAR IMAGING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

64040 HIGHWAY 434 SUITE 200
LACOMBE LA
70445-3456
US

IV. Provider business mailing address

64040 HIGHWAY 434 SUITE 200
LACOMBE LA
70445-3456
US

V. Phone/Fax

Practice location:
  • Phone: 985-892-9233
  • Fax: 985-871-9345
Mailing address:
  • Phone: 985-892-9233
  • Fax: 985-871-9345

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES EMERSON SMITH III
Title or Position: PRESIDENT
Credential: M.D.
Phone: 985-892-9233