Provider Demographics
NPI:1528099975
Name:ORTHOPAEDIC IMAGING OF OPELOUSAS
Entity type:Organization
Organization Name:ORTHOPAEDIC IMAGING OF OPELOUSAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PART OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:R
Authorized Official - Last Name:BUTAUD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-942-6503
Mailing Address - Street 1:4015 HWY I-49 SOUTH SERVICE RD
Mailing Address - Street 2:
Mailing Address - City:OPELOUSAS
Mailing Address - State:LA
Mailing Address - Zip Code:70570
Mailing Address - Country:US
Mailing Address - Phone:337-942-6503
Mailing Address - Fax:337-942-8831
Practice Address - Street 1:4015 HWY I-49 SOUTH SERVICE RD
Practice Address - Street 2:
Practice Address - City:OPELOUSAS
Practice Address - State:LA
Practice Address - Zip Code:70570
Practice Address - Country:US
Practice Address - Phone:337-942-6503
Practice Address - Fax:337-942-8831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody ImagingGroup - Multi-Specialty