Urology Clinic Of Northeast Louisiana - A Medical Corporation

NPI 1760418396 - Urology - 208800000X

NPI Details
NPI 1760418396
Enumeration Date 06/24/2006
Last Updated 10/19/2012
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name JON BRADLEY JON
Position PHYSICIAN OWNER
Phone (318) 387-9420
Fax (318) 323-8216
Practice Location
711 SAINT JOHN STREET
MONROE LA, 71201-8435, US
Phone (318) 387-9420
Fax (318) 323-8216
Business Location
711 SAINT JOHN STREET
MONROE LA, 71201-8435, US
Phone (318) 387-9420
Fax (318) 323-8216
Toxanomy
Taxonomy Code 208800000X
License State Louisiana
License Number 013314
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According to our database, Urology Clinic Of Northeast Louisiana - A Medical Corporation NPI is 1760418396, taxonomy code is 208800000X and license number is 013314, license state is located at Louisiana. Urology Clinic Of Northeast Louisiana - A Medical Corporation physically located at 711 Saint John Street, Monroe LA, 71201-8435. NPI Number 1033115704 has the healthcare provider type.

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1760418396 NPI number is provided on an as is basis without warranty of any kind. 1760418396 is maintained by the National Plan & Provider Enumeration System. The contents of Urology Clinic Of Northeast Louisiana - A Medical Corporation are for informational purposes only.