Physician Group of Louisiana Inc
Organization Active NPI Family Medicine Physician · West Monroe, LA
NPI 1013486059 · NPPES record last updated Nov 20, 2018
Key facts
- NPI
- 1013486059
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- PHYSICIAN GROUP OF LOUISIANA INC
- Practice address
- 1900 N 7TH St
West Monroe, LA 71291-4416 - Phone
- (318) 651-7000
- NPI assigned
- Nov 20, 2018
- Organization subpart
- No
Authorized official
- Name
- Jonathan A Demke
- Title
- Ceo
- Phone
- (615) 467-1072
Other NPIs on the same Medicare enrollment 1
Practitioners 60
-
William Edward Beebe, M.D.
-
Mark Edward Boersma, M.D.
-
Harry W. Donias, M.D.
-
Sherri Drake, FNP
-
John Weston Evans, PAC
-
David G Gardner, DPM
-
Carrie G Genusa, FNP
-
Jenny Guerre, MD
-
Ladolpha Person Hopkins, NURSE PRACTITIONER
-
Jeramy W Huff, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20091202000287 | LA | Part B Supplier - Clinic/Group Practice | 8921147067 |
Receives reassigned benefits from 63 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Monroe, LA; Sterlington, LA; West Monroe, LA |
National Provider Directory
Locations
3995 Sterlington Rd
Monroe, LA 71203
Phone (318) 329-8800
3106 Cypress St
West Monroe, LA 71291
Phone (318) 322-0458
3101 Cypress St
Ste 8
West Monroe, LA 71291
Phone (318) 644-2573
6200 Cypress St
West Monroe, LA 71291
Phone (318) 329-4525
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
1900 N 7TH St
West Monroe, LA 71291-4416
Mailing address
PO Box 281796
Atlanta, GA 30384-1796
Phone (866) 243-7107
Other names
- STEWARD MEDICAL GROUP OF LOUISIANA
Other providers in West Monroe, LA
- Alicia Hutson Peters
- Kimberly Ann Peters
- Brenda Zeagler Pettis
- Melissa Petz
- Brandon Lane Phillips
- Physician Group of Louisiana Inc
- Physician Group of Louisiana Inc
- Shari G. Picou
- Latoya Anderson Pierce
- Nancy B Pierron
All providers in West Monroe, LA · Family Medicine Physician in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 20, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.