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General NPI Number Information
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NPI Number | 1992828123
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Entity Type | Organization
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Legal Business Name | OUACHITA NEUROSURGERY CENTER A MEDICAL CORPORATION
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 05/29/2013
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Provider Practice Location Address
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Address Line | 212 WALNUT ST SUITE 110
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City | MONROE
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State | LA
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Zip | 71201-6700
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Country | US
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Telephone | 318-323-1809
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Fax | 318-323-2668
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Provider Business Mailing Address
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Address Line | 212 WALNUT ST SUITE 110
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City | MONROE
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State | LA
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Zip | 71201-6700
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Country | US
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Telephone | 318-323-1809
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Fax | 318-323-2668
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. BERNIE G. MCHUGH JR.
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Credential | M. D.
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Telephone | 318-323-1809
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 021731
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License Number State | LA
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