MEDICARE: DELTA MRI LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	046280	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134125693
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DELTA MRI LLC

Provider Business Mailing Address
First Line	:	PO BOX 6515
Second Line	:
City	:	METAIRIE
State	:	LA
Zip	:	70009-6515
Country	:	US
Telephone Number	:	504-620-5200
Fax Number	:	504-620-5203

Provider Business Practice Location Address
First Line	:	9900 LAKE FOREST BLVD
Second Line	:	STE N
City	:	NEW ORLEANS
State	:	LA
Zip	:	70127-5470
Country	:	US
Telephone Number	:	504-620-5200
Fax Number	:	504-620-5203

Authorized Official
Title or Position	:	PARTNER
Name	:	DR. STEVEN YELLIN
Credential	:	MD
Telephone Number	:	504-620-5200

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	08/22/2020

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