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General NPI Number Information
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NPI Number | 1942393699
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Entity Type | Organization
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Legal Business Name | BLUEBONNET IMAGING CENTER, LLC
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 4570 BLUEBONNET BLVD. SUITE B
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City | BATON ROUGE
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State | LA
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Zip | 70809
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Country | US
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Telephone | 225-298-3223
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Fax | 225-298-5474
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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 | 504-459-3220
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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 | 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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