Provider Demographics
NPI:1073642906
Name:DMX DIAGNOSTICS OF BATON ROUGE, INC
Entity Type:Organization
Organization Name:DMX DIAGNOSTICS OF BATON ROUGE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHARLENE
Authorized Official - Middle Name:PIKE
Authorized Official - Last Name:BOUDREAUX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-289-0882
Mailing Address - Street 1:718 S BUCHANAN ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70501-6820
Mailing Address - Country:US
Mailing Address - Phone:337-289-0882
Mailing Address - Fax:337-289-0304
Practice Address - Street 1:718 S BUCHANAN ST
Practice Address - Street 2:SUITE A
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70501-6820
Practice Address - Country:US
Practice Address - Phone:337-289-0882
Practice Address - Fax:337-289-0304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile