Provider Demographics
NPI:1851950158
Name:SMALLEST FOOTPRINTS 3D/4D ULTRASOUND LLC
Entity type:Organization
Organization Name:SMALLEST FOOTPRINTS 3D/4D ULTRASOUND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIAGNOSTIC MEDICAL SONO
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-344-8021
Mailing Address - Street 1:8952 TURNER DR
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71118-2729
Mailing Address - Country:US
Mailing Address - Phone:318-344-8021
Mailing Address - Fax:
Practice Address - Street 1:8870 YOUREE DR
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71115-2512
Practice Address - Country:US
Practice Address - Phone:318-344-8021
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-10
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0206XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mammography