Organization
PONTCHARTRAIN DIAGNOSTIC IMAGING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL DAVID HALL M.D. (RADIOLOGIST)
(985) 792-5537
Entity
Organization
Contact information
Practice address
95 JUDGE TANNER BLVD, COVINGTON, LA 70433-7500
(985) 867-4050
Mailing address
681 BOCAGE LN, MANDEVILLE, LA 70471-1605
(985) 792-5537
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
10/03/2012
Last updated
11/13/2012
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