Mobile Tech Medical Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

19D1001395 Issued in LA

Legal business name

MOBILE TECH MEDICAL INC.

Practice address

4336 North Blvd Ste 200
Baton Rouge, LA 70806-3920

Phone

(225) 267-6860

Fax

(225) 344-1133

NPI assigned

Apr 12, 2006

Last updated

Jan 8, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Ronald A Jenkins, N/A

Title

Owner

Phone

(225) 267-6860

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mobile Tech Medical laboratories Other name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452211200000",
    "number": "1073577730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4336 NORTH BLVD STE 200",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708063920",
            "telephone_number": "225-267-6860",
            "fax_number": "225-344-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4336 NORTH BLVD STE 200",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708063920",
            "telephone_number": "225-267-6860",
            "fax_number": "225-344-1133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE TECH MEDICAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-12",
        "last_updated": "2016-01-08",
        "status": "A",
        "authorized_official_last_name": "JENKINS",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "225-267-6860",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "N/A"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "LA",
            "license": "19D1001395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "18313",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mobile Tech Medical laboratories",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Mobile Spine LLC (Lagniappe Chiropractic & Wellness)
• Chandrill Mobley, MPH
• Sarah Mobley
• Walnita Mobley
• Jamileh Moezivaziri
• Marguerite Mary Moffatt, N.P.

• Clinical Medical Laboratory in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Clinical Medical Laboratory in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.