MAGNOLIA DIAGONSTIC SERVICES INC. NPI 1821225806

NPI Information

NPI: 1821225806
Provider Name: MAGNOLIA DIAGONSTIC SERVICES INC.

Former Legal Business Name: NO

Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

Address:
2005 CRESWELL AVE
SHREVEPORT, LA
ZIP 71104
Phone: (318) 678-0709
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MAGNOLIA DIAGONSTIC SERVICES INC. is a multi-specialty clinic center in Shreveport, LA. MAGNOLIA DIAGONSTIC SERVICES INC. NPI is 1821225806. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is No.

The provider's business location address is:

2005 CRESWELL AVE
SHREVEPORT, LA
ZIP 71104-201
Phone: (318) 678-0709

The provider's authorized official is Dewarrent L. Brantley .
The authorized official title is Ceo/ President and has the following contact phone number (318) 678-0709.

The enumeration date for this NPI number is 6/17/2009 and was last updated on 6/17/2009.

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	261QM1300X	Clinic/Center	Multi-Specialty			Yes

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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