Provider Demographics
NPI:1134133911
Name:OPENSIDED MRI OF NEW ORLEANS
Entity Type:Organization
Organization Name:OPENSIDED MRI OF NEW ORLEANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BILLING
Authorized Official - Prefix:MR
Authorized Official - First Name:BILL
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-781-3922
Mailing Address - Street 1:1 GALLERIA BLVD
Mailing Address - Street 2:STE 715
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-2082
Mailing Address - Country:US
Mailing Address - Phone:504-837-6736
Mailing Address - Fax:504-837-0835
Practice Address - Street 1:1 GALLERIA BLVD
Practice Address - Street 2:STE 715
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-2082
Practice Address - Country:US
Practice Address - Phone:504-837-6736
Practice Address - Fax:504-837-0835
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471M1202XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMagnetic Resonance ImagingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5C379Medicare ID - Type Unspecified