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General NPI Number Information
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NPI Number | 1255440103
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Entity Type | Organization
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Legal Business Name | PATHOLOGY ASSOCIATES
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 10/02/2007
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Provider Practice Location Address
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Address Line | 309 JACKSON ST
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City | MONROE
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State | LA
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Zip | 71201-7407
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Country | US
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Telephone | 318-322-7276
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3125
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City | MONROE
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State | LA
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Zip | 71210-3125
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Country | US
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Telephone | 318-322-7276
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | JAMES WESLEY GEISLER
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Credential | MD
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Telephone | 318-222-7276
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 01969R
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License Number State | LA
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