DR. THOMPSON MACK DIETZ MD NPI 1083619241

NPI Information

NPI: 1083619241
Provider Name: DR. THOMPSON MACK DIETZ, MD
Classification: Radiology - 2085R0202X
Entity Type: Individual

Specialization: Diagnostic Radiology

PECOS Registration: Yes

Address:
1495 GAUSE BLVD
SLIDELL, LA
ZIP 70458
Phone: (985) 405-5200
Get Directions

DR. Thompson Mack Dietz, MD is a diagnostic radiology radiology in Slidell, LA. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. DR. Thompson Mack Dietz, MD NPI is 1083619241. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1495 GAUSE BLVD
SLIDELL, LA
ZIP 70458-205
Phone: (985) 405-5200
Fax: (985) 405-5201

The NPI 1083619241 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/15/2005 and was last updated on 2/20/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085R0202X	Radiology	Diagnostic Radiology	013772	LOUISIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	05721306	MEDICARE PIN	MISSISSIPPI
2	E39015	MEDICARE UPIN
3	5M318	MEDICARE PIN	LOUISIANA
4	1323764	MEDICAID	LOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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