Organization
NORTHEAST LOUISIANA RADIOLOGY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENTON MCDONALD M.D. (PHYSICIAN)
(318) 283-4483
Entity
Organization
Contact information
Practice address
1813 NORTHPOINTE LN, RUSTON, LA 71270-3879
(318) 255-7591
(318) 255-7584
Mailing address
1813 NORTHPOINTE LN, RUSTON, LA 71270-3879
(318) 255-7591
(318) 255-7584
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
137419002
—
AR
05
—
1949523
—
LA
01
—
CF8948
RAILROAD MEDICARE
—
Enumeration date
06/20/2006
Last updated
04/05/2016
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