Healthcare Provider Details
I. General information
NPI: 1932154846
Provider Name (Legal Business Name): ST FRANCIS MEDICAL CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/23/2006
Last Update Date: 07/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
312 GRAMMONT STREET SUITE 401
MONROE LA
71201-7385
US
IV. Provider business mailing address
312 GRAMMONT STREET STE 401
MONROE LA
71201-7385
US
V. Phone/Fax
- Phone: 318-361-0085
- Fax: 318-325-3501
- Phone: 318-361-0085
- Fax: 318-325-3501
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2086S0129X |
| Taxonomy | Vascular Surgery Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208G00000X |
| Taxonomy | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
RONALD
E
HOGAN
Title or Position: CFO/VP OF FINANCE SFMC
Credential:
Phone: 318-327-7369