Organization
MED IMAGE MANAGEMENT & CONSULTANTS LLC
Active
Other names
American Mobile Medical of Acadiana
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CALVIN DALE VIDRINE CRA RT R N (PRESIDENT CEO)
(337) 594-9637
Entity
Organization
Contact information
Practice address
174 GRANT RD, OPELOUSAS, LA 70570-0720
(337) 594-9637
(337) 948-4556
Mailing address
174 GRANT RD, OPELOUSAS, LA 70570-0720
(337) 594-9637
(337) 948-4556
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
1004
LA
2085R0202X
Diagnostic Radiology Physician
1005
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1664669
—
LA
01
—
P00238881
RAILROAD RETIREMENT MEDIC
LA
Enumeration date
11/15/2005
Last updated
04/20/2008
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