Organization
BAYOU IMAGING & INTERVENTIONS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GINGER AUER BLACK MD (MD/OWNER)
(318) 210-3315
Entity
Organization
Contact information
Practice address
708 N ASHLEY RIDGE LOOP, SHREVEPORT, LA 71106
(318) 798-4539
(318) 798-4601
Mailing address
708 N ASHLEY RIDGE LOOP, #400, SHREVEPORT, LA 71106
(318) 798-4539
(318) 798-4601
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
200722
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2411187
—
LA
Enumeration date
04/05/2013
Last updated
03/21/2016
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