Organization
MOBILE X-RAY SERVICES OF SHREVEPORT BOSSIER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEAGAN MOTON (PRESIDENT)
(318) 687-6861
Entity
Organization
Contact information
Practice address
670 ALBEMARLE DR STE 202, SHREVEPORT, LA 71106-5946
(318) 687-6861
(318) 687-6768
Mailing address
670 ALBEMARLE DR STE 202, SHREVEPORT, LA 71106-5946
(318) 687-6861
(318) 687-6768
Taxonomy
Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13066
BC BS PROVIDER NUMBER
LA
05
—
1317497
—
LA
01
—
630000359
RR MEDICARE PROVIDER NUMB
LA
Enumeration date
01/13/2007
Last updated
03/29/2021
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