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NPI Code Detail

MEDICARE: OPEN AIR MRI OF ACADIANA LLC

MEDICARE: OPEN AIR MRI OF ACADIANA 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
12085R0202XDiagnostic Radiology Physician

Other Identifiers

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

General Provider Information

NPI Number : 1841299476
Entity Type Code : Organization
Provider Name (Legal Business Name) : OPEN AIR MRI OF ACADIANA LLC
Provider Business Mailing Address
First Line : 1305 CROWLEY RAYNE HWY
Second Line : SUITE A
City : CROWLEY
State : LA
Zip : 70526-8202
Country : US
Telephone Number : 337-783-5577
Fax Number : 337-783-9118
Provider Business Practice Location Address
First Line : 1305 CROWLEY RAYNE HWY
Second Line : SUITE A
City : CROWLEY
State : LA
Zip : 70526-8202
Country : US
Telephone Number : 337-783-5577
Fax Number : 337-783-9118
Authorized Official
Title or Position : CHIEF OPERATING OFFICER
Name : JAMES W. HOLMES
Credential :
Telephone Number : 337-291-9161
Provider Enumeration Date : 07/15/2005
Last Update Date : 02/15/2008

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