Provider Demographics
NPI:1134125693
Name:DELTA MRI LLC
Entity Type:Organization
Organization Name:DELTA MRI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:YELLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-620-5200
Mailing Address - Street 1:PO BOX 6515
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70009-6515
Mailing Address - Country:US
Mailing Address - Phone:504-620-5200
Mailing Address - Fax:504-620-5203
Practice Address - Street 1:9900 LAKE FOREST BLVD
Practice Address - Street 2:STE N
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70127-5470
Practice Address - Country:US
Practice Address - Phone:504-620-5200
Practice Address - Fax:504-620-5203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA0462802085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1443158Medicaid
LA5CC28Medicare ID - Type Unspecified