Healthcare Provider Details

I. General information

NPI: 1518922731
Provider Name (Legal Business Name): MOLECULAR IMAGING OF LOUISIANA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4525 WESTBANK EXPY
MARRERO LA
70072-3120
US

IV. Provider business mailing address

4525 WESTBANK EXPY
MARRERO LA
70072-3120
US

V. Phone/Fax

Practice location:
  • Phone: 504-349-6203
  • Fax: 504-349-6189
Mailing address:
  • Phone: 504-349-6203
  • Fax: 504-349-6189

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: ROBERT M. KESSLER
Title or Position: DIRECTOR
Credential: MD
Phone: 504-342-4708