Healthcare Provider Details

I. General information

NPI: 1871544585
Provider Name (Legal Business Name): WOMAN'S CLINIC OF MONROE, AMC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 01/14/2022
Certification Date: 01/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 GRAMMONT ST SUITE 300
MONROE LA
71201-7457
US

IV. Provider business mailing address

312 GRAMMONT ST SUITE 300
MONROE LA
71201-7457
US

V. Phone/Fax

Practice location:
  • Phone: 318-388-4030
  • Fax: 318-325-8437
Mailing address:
  • Phone: 318-388-4030
  • Fax: 318-998-3999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: RHONDA MCDONALD
Title or Position: DIRECTOR OF INSURANCE
Credential:
Phone: 318-388-4030