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General NPI Number Information
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NPI Number | 1033215710
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Entity Type | Organization
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Legal Business Name | RADIOLOGY ASSOCIATES OF SOUTHWEST LOUISIANA
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Dates
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Enumeration Date | 09/16/2006
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Last Update Date | 07/21/2025
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Provider Practice Location Address
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Address Line | 3704 NORTH BLVD
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City | ALEXANDRIA
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State | LA
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Zip | 71301-3658
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Country | US
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Telephone | 318-545-4038
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 919112
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City | DALLAS
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State | TX
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Zip | 75391-9112
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Country | US
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Telephone | 337-439-4706
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Fax | 337-439-8110
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Authorized Official
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Title or Position | DIRECTOR
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Name | WENDY LEE FOUNTAIN
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Credential |
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Telephone | 321-331-4253
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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