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General NPI Number Information
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NPI Number | 1346280021
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Entity Type | Organization
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Legal Business Name | CARLSBAD OPEN MRI
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 02/10/2015
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Provider Practice Location Address
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Address Line | 2319 WEST PIERCE STREET, SUITE A
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City | CARLSBAD
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State | NM
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Zip | 88220
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Country | US
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Telephone | 505-628-1234
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Fax | 505-628-3215
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Provider Business Mailing Address
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Address Line | 2319 WEST PIERCE STREET, SUITE A
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City | CARLSBAD
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State | NM
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Zip | 88220
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Country | US
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Telephone | 505-628-1234
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Fax | 505-628-3215
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | MR. KEMP B LAIDLEY
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Credential |
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Telephone | 505-628-1234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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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 | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | 53169-01
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License Number State | NM
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