Provider Demographics
NPI:1598791188
Name:OGH IMAGING, LLC
Entity type:Organization
Organization Name:OGH IMAGING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF IMAGING
Authorized Official - Prefix:
Authorized Official - First Name:LESSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DOUCET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-407-4523
Mailing Address - Street 1:PO BOX 437
Mailing Address - Street 2:
Mailing Address - City:GRAND COTEAU
Mailing Address - State:LA
Mailing Address - Zip Code:70541-0437
Mailing Address - Country:US
Mailing Address - Phone:337-407-4523
Mailing Address - Fax:337-261-2697
Practice Address - Street 1:1341 1-49 S. SERVICE RD
Practice Address - Street 2:
Practice Address - City:GRAND COTEAU
Practice Address - State:LA
Practice Address - Zip Code:70541
Practice Address - Country:US
Practice Address - Phone:337-407-4523
Practice Address - Fax:337-210-3031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5DA13Medicare ID - Type Unspecified