Healthcare Provider Details

I. General information

NPI: 1457348609
Provider Name (Legal Business Name): SOUTHWEST IMAGING ASSOCIATES, APMC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2810 AMBASSADOR CAFFERY PKWY
LAFAYETTE LA
70506-5906
US

IV. Provider business mailing address

PO BOX 51716
LAFAYETTE LA
70505-1716
US

V. Phone/Fax

Practice location:
  • Phone: 337-261-5151
  • Fax:
Mailing address:
  • Phone: 337-261-5151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number017848
License Number StateLA

VIII. Authorized Official

Name: DR. JAMES MCCARTHY
Title or Position: OWNER
Credential: MD
Phone: 337-261-5151