# INDIANA MRI OF LAFAYETTE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Open MRI of Lafayette
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669475687
- **Authorized official:** MRS. MICHELLE DOUGLAS (CREDENTIALING MANAGER)
- **Authorized official phone:** (502) 403-1401

## Contact information

- **Practice address:** 130 PROFESSIONAL CT, STE C, LAFAYETTE, IN 47905-5153
- **Practice address phone:** (765) 449-7984
- **Practice address fax:** (765) 449-9791
- **Mailing address:** 130 PROFESSIONAL CT, STE C, LAFAYETTE, IN 47905-5153
- **Mailing address phone:** (765) 449-7984
- **Mailing address fax:** (765) 449-9791

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1200X | Magnetic Resonance Imaging (MRI) Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/23/2005
- **Last updated:** 06/12/2008