Organization
SOUTHERN DIAGNOSTIC CENTER, INC.
Active
Other names
Laborde Diagnotics at South College
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DONNA G ROBINSON (OFFICE CONTRACT MANAGER)
(337) 269-5990
Entity
Organization
Contact information
Practice address
1101 S COLLEGE RD, SUITE 200, LAFAYETTE, LA 70503-3038
(337) 269-5990
(337) 232-3295
Mailing address
1101 S COLLEGE RD, SUITE 200, LAFAYETTE, LA 70503-3038
(337) 269-5990
(337) 232-3295
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1793981
—
LA
01
—
300071001
MEDICARE RAILROAD RET
LA
Enumeration date
05/25/2006
Last updated
01/12/2010
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