Healthcare Provider Details

I. General information

NPI: 1164953022
Provider Name (Legal Business Name): MONIQUE GLORIA MONARD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2017
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1318 HARRISON AVE
MCCOMB MS
39648-2830
US

IV. Provider business mailing address

PO BOX 490
MCCOMB MS
39649-0490
US

V. Phone/Fax

Practice location:
  • Phone: 601-684-2300
  • Fax: 601-684-2360
Mailing address:
  • Phone: 601-250-4366
  • Fax: 601-250-4367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number35933
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME150838
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: