Organization
LOUISIANA PET/CT IMAGING OF LAKE CHARLES. LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN STAGG (CEO)
(225) 952-9141
Entity
Organization
Contact information
Practice address
831 LAKE SHORE DR, LAKE CHARLES, LA 70601-4290
(337) 433-3001
(337) 433-0540
Mailing address
4241 VETERANS MEMORIAL BLVD STE 200, METAIRIE, LA 70006-5430
(888) 273-3445
(504) 883-5384
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
LA 10292-L01
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2418459
—
LA
Enumeration date
07/26/2006
Last updated
10/25/2022
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