Healthcare Provider Details

I. General information

NPI: 1811926470
Provider Name (Legal Business Name): LOUIE VERNON CROOK JR. M. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

309 JACKSON ST
MONROE LA
71201-7407
US

IV. Provider business mailing address

6061 OAK RIDGE RD
MER ROUGE LA
71261-9511
US

V. Phone/Fax

Practice location:
  • Phone: 318-327-4000
  • Fax:
Mailing address:
  • Phone: 318-647-3518
  • Fax: 318-647-5369

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number015549
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: