Organization
MEDICAL CENTER DIAGNOSTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL N PITTMAN MD (CEO OWNER)
(985) 809-0000
Entity
Organization
Contact information
Practice address
67250 INDUSTRY LANE, COVINGTON, LA 70433
(985) 809-0000
(985) 898-3827
Mailing address
67250 INDUSTRY LANE, COVINGTON, LA 70433
(985) 809-0000
(985) 898-3827
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1938934
—
LA
01
—
F1152
BLUE CROSS
LA
01
—
G1502
BLUE CROSS
LA
Enumeration date
04/19/2006
Last updated
08/22/2020
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