Organization
BLUEBONNET IMAGING CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN P STAGG (CEO)
(225) 270-7077
Entity
Organization
Contact information
Practice address
4570 BLUEBONNET BLVD., SUITE B, BATON ROUGE, LA 70809
(225) 298-3223
(225) 298-5474
Mailing address
4241 VETERANS MEMORIAL BLVD STE 200, METAIRIE, LA 70006-5430
(504) 459-3220
(504) 883-5384
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1025666
—
LA
Enumeration date
10/02/2006
Last updated
10/09/2024
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