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General NPI Number Information
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NPI Number | 1710935929
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Entity Type | Organization
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Legal Business Name | IMAGING CENTER OF MERIDIAN LLC
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 2021 24TH AVE SUITE B
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City | MERIDIAN
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State | MS
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Zip | 39301-3121
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Country | US
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Telephone | 601-483-4339
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Fax | 601-483-4516
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Provider Business Mailing Address
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Address Line | 4241 VETERANS MEMORIAL BLVD STE 200
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City | METAIRIE
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State | LA
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Zip | 70006-5430
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Country | US
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Telephone | 504-459-3201
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Fax | 504-883-5384
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Authorized Official
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Title or Position | CEO
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Name | JOHN P STAGG
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Credential |
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Telephone | 225-270-7077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number |
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License Number State |
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