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General NPI Number Information
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NPI Number | 1649442013
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Entity Type | Organization
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Legal Business Name | IMAGING SERVICES OF LOUISIANA LLC
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Dates
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Enumeration Date | 03/26/2008
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Last Update Date | 10/20/2010
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Provider Practice Location Address
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Address Line | 5000 AMBASSADOR CAFFERY PARKWAY BLDG 10
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City | LAFAYETTE
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State | LA
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Zip | 70508
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Country | US
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Telephone | 337-993-8300
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Fax | 337-521-9159
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Provider Business Mailing Address
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Address Line | 5000 AMBASSADOR CAFFERY PARKWAY BLDG 10
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City | LAFAYETTE
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State | LA
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Zip | 70508
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Country | US
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Telephone | 337-993-8300
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Fax | 337-521-9159
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Authorized Official
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Title or Position | IMAGING/ONCOLOGY MANGED CARE ANALYS
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Name | LAVELLE HARDIN
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Credential |
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Telephone | 615-372-5441
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State |
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