Provider Demographics
NPI:1770841470
Name:CRESCENT CITY DIAGNOSTICS INC.
Entity Type:Organization
Organization Name:CRESCENT CITY DIAGNOSTICS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:KEEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-858-3584
Mailing Address - Street 1:617 E JUDGE PEREZ DR
Mailing Address - Street 2:
Mailing Address - City:CHALMETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70043-5260
Mailing Address - Country:US
Mailing Address - Phone:504-309-5077
Mailing Address - Fax:
Practice Address - Street 1:617 E JUDGE PEREZ DR
Practice Address - Street 2:
Practice Address - City:CHALMETTE
Practice Address - State:LA
Practice Address - Zip Code:70043-5260
Practice Address - Country:US
Practice Address - Phone:504-309-5077
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-01
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)