Healthcare Provider Details

I. General information

NPI: 1629132998
Provider Name (Legal Business Name): OUACHITA DIAGNOSTIC IMAGING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2008A LOUISVILLE AVE.
MONROE LA
71201
US

IV. Provider business mailing address

PO BOX 2304
MONROE LA
71207-2304
US

V. Phone/Fax

Practice location:
  • Phone: 318-398-2969
  • Fax: 318-398-2965
Mailing address:
  • Phone: 318-398-2969
  • Fax: 318-398-2965

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2471C3401X
TaxonomyComputed Tomography Radiologic Technologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2471M1202X
TaxonomyMagnetic Resonance Imaging Radiologic Technologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2471C3402X
TaxonomyRadiography Radiologic Technologist
License Number
License Number State

VIII. Authorized Official

Name: PAM C COWART
Title or Position: OFFICE MANAGER
Credential:
Phone: 318-398-2969