Healthcare Provider Details
I. General information
NPI: 1386235331
Provider Name (Legal Business Name): MONROE EMERGENCY PHYSICIANS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/02/2021
Last Update Date: 12/06/2023
Certification Date: 12/06/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
309 JACKSON ST
MONROE LA
71201-7407
US
IV. Provider business mailing address
400 GALLERIA PKWY SE STE 1755
ATLANTA GA
30339-5934
US
V. Phone/Fax
- Phone: 404-500-8147
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207PE0004X |
| Taxonomy | Emergency Medical Services (Emergency Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
BOYKIN
ROBINSON
Title or Position: CEO
Credential: MD
Phone: 404-500-8147