Affinity Health Group, LLC
Family Medicine in Monroe, LA. Organization (NPI-2).
NPI number1053734780
StatusActive
Last updated in NPPESJan 31, 2014
Details
- NPI
- 1053734780
- Entity type
- Organization (NPI-2)
- Legal business name
- Affinity Health Group, LLC
- Organization subpart
- No
- Enumeration date
- Jan 31, 2014
- Last updated
- Jan 31, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
| 363L00000X | Nurse Practitioner | – | – |
Other names
- Affinity Health Group Ulm Clinic (Doing Business As)
Practice location
1140 University AveMonroe, LA 71209-0001
Phone 318-342-1651 · Fax 318-342-3280
Mailing address
130 Desiard StSuite 355
Monroe, LA 71201-7319
Phone 318-807-7875 · Fax 318-812-6603
Authorized official
Mike Breard
Vice President
3183610900
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