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General NPI Number Information
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NPI Number | 1336688464
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Entity Type | Organization
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Legal Business Name | WELL WOMANS CENTER OF LOUISIANA
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Dates
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Enumeration Date | 02/22/2017
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Last Update Date | 02/22/2017
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Provider Practice Location Address
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Address Line | 708 JACKSON ST
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City | MONROE
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State | LA
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Zip | 71201-8420
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Country | US
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Telephone | 318-479-2229
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Fax | 318-737-7757
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Provider Business Mailing Address
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Address Line | 708 JACKSON ST
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City | MONROE
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State | LA
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Zip | 71201-8420
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Country | US
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Telephone | 318-479-2229
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Fax | 318-737-7757
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | DR. TONYA H HUNTER
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Credential | M.D.
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Telephone | 318-479-2229
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD.024411
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License Number State | LA
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