| Organization Name: | DEER CREEK IMAGING CENTER |
| NPI Number: | 1013900760 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GREGORY D LORD (MANAGING DIRECTOR) |
| Mailing Address: | 301 W Fertitta Blvd Ste 1 Leesville |
| State: | LA US |
| Postal Code: | 714464665 |
| Phone Number: | 3373921363 |
| Fax Number: | |
| NPI Enumeration Date: | 08/29/2005 |
| NPI Last Update Date: | 04/20/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM1200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Magnetic Resonance Imaging (MRI) |
| Taxonomy Definition: | |