Healthcare Provider Details

I. General information

NPI: 1134133911
Provider Name (Legal Business Name): OPENSIDED MRI OF NEW ORLEANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 GALLERIA BLVD STE 715
METAIRIE LA
70001-2082
US

IV. Provider business mailing address

1 GALLERIA BLVD STE 715
METAIRIE LA
70001-2082
US

V. Phone/Fax

Practice location:
  • Phone: 504-837-6736
  • Fax: 504-837-0835
Mailing address:
  • Phone: 504-837-6736
  • Fax: 504-837-0835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471M1202X
TaxonomyMagnetic Resonance Imaging Radiologic Technologist
License Number
License Number State

VIII. Authorized Official

Name: MR. BILL DAVIES
Title or Position: DIRECTOR OF BILLING
Credential:
Phone: 706-781-3922