Provider Demographics
NPI:1518922731
Name:MOLECULAR IMAGING OF LOUISIANA, LLC
Entity Type:Organization
Organization Name:MOLECULAR IMAGING OF LOUISIANA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:KESSLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-342-4708
Mailing Address - Street 1:4525 WESTBANK EXPY
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-3120
Mailing Address - Country:US
Mailing Address - Phone:504-349-6203
Mailing Address - Fax:504-349-6189
Practice Address - Street 1:4525 WESTBANK EXPY
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-3120
Practice Address - Country:US
Practice Address - Phone:504-349-6203
Practice Address - Fax:504-349-6189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5CF77Medicare ID - Type Unspecified