Organization
OPEN AIR MRI OF LAKE CHARLES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES W. HOLMES (CHIEF OPERATING OFFICER)
(337) 291-9161
Entity
Organization
Contact information
Practice address
3114 LAKE ST, LAKE CHARLES, LA 70601
(337) 474-3333
(337) 474-3330
Mailing address
3114 LAKE ST, LAKE CHARLES, LA 70601
(337) 474-3333
(337) 474-3330
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1949884
—
LA
Enumeration date
07/15/2005
Last updated
02/11/2008
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