Provider Demographics
NPI:1700070141
Name:PHYSICIANS IMAGING - SULPHUR ASSOCIATES, LLC
Entity Type:Organization
Organization Name:PHYSICIANS IMAGING - SULPHUR ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:H
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:337-310-8834
Mailing Address - Street 1:250 BEGLIS PKWY
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SULPHUR
Mailing Address - State:LA
Mailing Address - Zip Code:70663-3500
Mailing Address - Country:US
Mailing Address - Phone:337-310-8834
Mailing Address - Fax:
Practice Address - Street 1:250 BEGLIS PKWY
Practice Address - Street 2:SUITE 2
Practice Address - City:SULPHUR
Practice Address - State:LA
Practice Address - Zip Code:70663-3500
Practice Address - Country:US
Practice Address - Phone:337-310-8834
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-29
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA261QM1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)