Organization
NORTHWEST IMAGING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAMRA S GAUTHIER (VICE PRESIDENT)
(225) 930-0060
Entity
Organization
Contact information
Practice address
1460 E. BERT KOUNS INDUSTRIAL LOOP, SUITE 708, SHREVEPORT, LA 71105
(318) 425-1001
(318) 425-5001
Mailing address
3500 N. CAUSEWAY BLVD, SUITE 1000, METAIRIE, LA 70002
(504) 838-1200
(504) 838-1239
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1445045
—
LA
Enumeration date
10/03/2006
Last updated
02/24/2020
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