Provider Demographics
NPI:1427134683
Name:RADIOLOGY SPECIALTY GROUP LLC
Entity type:Organization
Organization Name:RADIOLOGY SPECIALTY GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DIANNE
Authorized Official - Middle Name:E
Authorized Official - Last Name:LAFLEUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-298-2445
Mailing Address - Street 1:PO BOX 8278
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71306-1278
Mailing Address - Country:US
Mailing Address - Phone:888-554-8444
Mailing Address - Fax:318-484-5289
Practice Address - Street 1:4231 HWY 1192
Practice Address - Street 2:
Practice Address - City:MARKSVILLE
Practice Address - State:LA
Practice Address - Zip Code:71351-4711
Practice Address - Country:US
Practice Address - Phone:318-792-1416
Practice Address - Fax:318-484-5289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1792632Medicaid
5C111Medicare ID - Type Unspecified