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General NPI Number Information
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NPI Number | 1811324882
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Entity Type | Organization
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Legal Business Name | BRFHH MONROE LLC
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Dates
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Enumeration Date | 10/04/2013
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Last Update Date | 06/28/2023
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Provider Practice Location Address
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Address Line | 4864 JACKSON ST
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City | MONROE
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State | LA
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Zip | 71202-6400
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Country | US
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Telephone | 318-330-7596
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Fax | 318-330-7596
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Provider Business Mailing Address
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Address Line | 4864 JACKSON ST
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City | MONROE
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State | LA
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Zip | 71202-6400
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Country | US
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Telephone | 318-330-7596
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Fax | 318-330-7596
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. MITZI GREEN
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Credential |
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Telephone | 318-626-0000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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