Organization
MGA GASTROINTESTINAL DIAGNOSTIC & THERAPEUTIC CENTER
Active
Other names
MGA Gastrointestinal Diagnostic and Therapeutic Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER A HOLDEN (CHIEF MANAGER OF LLC)
(615) 665-1283
Entity
Organization
Contact information
Practice address
1111 MEDICAL CENTER BLVD, S450, MARRERO, LA 70072-3151
(504) 349-6309
Mailing address
PO BOX 1187, MARRERO, LA 70073-1187
(504) 349-6423
Taxonomy
Speciality
Code
Description
License number
State
261QE0800X
Endoscopy Clinic/Center
Primary
60
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1980714
—
LA
Enumeration date
07/15/2006
Last updated
09/28/2007
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