Individual
RICHARD WILLIAM MANKINEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-3480
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-3480
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
MD.205289
LA
2085R0202X
Diagnostic Radiology Physician
LL30044
SC
2085R0202X
Diagnostic Radiology Physician
MD0000046071
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03076556
—
MS
05
—
2197452
—
LA
Enumeration date
07/23/2007
Last updated
10/26/2012
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