Healthcare Provider Details

I. General information

NPI: 1699793166
Provider Name (Legal Business Name): DIAGNOSTIC IMAGING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 05/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4241 VETERANS BLVD SUITE 100
METAIRIE LA
70006
US

IV. Provider business mailing address

4241 VETERANS BLVD SUITE 200
METAIRIE LA
70006
US

V. Phone/Fax

Practice location:
  • Phone: 504-888-7921
  • Fax: 504-883-5362
Mailing address:
  • Phone: 504-888-7921
  • Fax: 504-883-5384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Internal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL KYLE BURTNETT
Title or Position: SVP OF OUTPATIENT, TENET
Credential:
Phone: 469-893-2153