Organization
NORTHLAKE RADIOLOGY CONSULTANTS, APMC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KLAR A ROVIRA IV M.D. (PARTNER)
(985) 646-0691
Entity
Organization
Contact information
Practice address
1001 GAUSE BLVD, SLIDELL, LA 70458-2939
(985) 649-8545
Mailing address
PO BOX 2710, SLIDELL, LA 70459-2710
(985) 646-0691
(985) 646-0750
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05974773
—
MS
05
—
08927838
—
MS
05
—
09012709
—
MS
Enumeration date
05/05/2006
Last updated
01/12/2010
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