Affinity Health Group, LLC
Family Medicine in Monroe, LA. Organization (NPI-2).
NPI number1184791287
StatusActive
Last updated in NPPESJul 5, 2011
Details
- NPI
- 1184791287
- Entity type
- Organization (NPI-2)
- Legal business name
- Affinity Health Group, LLC
- Organization subpart
- No
- Enumeration date
- Nov 30, 2006
- Last updated
- Jul 5, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | MD016846 | LA | Yes |
| 363LF0000X | Nurse Practitioner, Family | AP04747 | LA |
Other names
- The Medical Office (Doing Business As)
Practice location
112 Saint John StMonroe, LA 71201-7322
Phone 318-387-5681 · Fax 318-322-9957
Mailing address
130 Desiard StSte 355
Monroe, LA 71201-7319
Phone 318-807-7875 · Fax 318-812-9997
Authorized official
Mike Breard
Vice President
3183610900
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