Thompson Mack Dietz IV MD

NPI 1083619241 - Radiology - 2085R0202X

NPI Details
NPI 1083619241
Gender Male
Enumeration Date 06/15/2005
Last Updated 02/20/2008
Entity Type Individual
Active Over 11 years ago
Practice Location
1495 GAUSE BLVD
SLIDELL LA, 70458-2205, US
Phone (985) 405-5200
Fax (985) 405-5201
Business Location
PO BOX 8861
METAIRIE LA, 70011-8861, US
Phone (985) 405-5200
Fax (985) 405-5201
Toxanomy
Taxonomy Code 2085R0202X
License State Louisiana
License Number 013772
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According to our database, Dr. Thompson Mack Dietz IV MD NPI is 1083619241, taxonomy code is 2085R0202X and license number is 013772, license state is located at Louisiana. Thompson Mack Dietz IV MD physically located at 1495 Gause Blvd, Slidell LA, 70458-2205. NPI Number Thompson Mack Dietz IV MD has the Individual type.

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1083619241 NPI number is provided on an as is basis without warranty of any kind. 1083619241 is maintained by the National Plan & Provider Enumeration System. The contents of Thompson Mack Dietz IV MD are for informational purposes only.