# AFFINITY HEALTH GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Affinity Central Lab
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003297227
- **Authorized official:** MIKE BREARD (EXECUTIVE VICE PRESIDENT)
- **Authorized official phone:** (318) 361-0900

## Contact information

- **Practice address:** 920 OLIVER RD, SUITE C, MONROE, LA 71201-5702
- **Practice address phone:** (318) 812-7050
- **Practice address fax:** (318) 812-7053
- **Mailing address:** 130 DESIARD ST, SUITE 355, MONROE, LA 71201-7319
- **Mailing address phone:** (318) 807-7875
- **Mailing address fax:** (318) 812-6603

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207RC0000X | Cardiovascular Disease Physician | — | NULL | — |
| 207RC0000X | Cardiovascular Disease Physician | — | — | — |
| 207RC0001X | Clinical Cardiac Electrophysiology Physician | — | NULL | — |
| 207RC0001X | Clinical Cardiac Electrophysiology Physician | — | — | — |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | — | NULL | — |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | — | — | — |
| 207Y00000X | Otolaryngology Physician | — | NULL | — |
| 207Y00000X | Otolaryngology Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 2084P0800X | Psychiatry Physician | — | NULL | — |
| 2084P0800X | Psychiatry Physician | — | — | — |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 208800000X | Urology Physician | — | NULL | — |
| 208800000X | Urology Physician | — | — | — |
| 208D00000X | General Practice Physician | — | NULL | — |
| 208D00000X | General Practice Physician | — | — | — |

## Other

- **Enumeration date:** 06/12/2015
- **Last updated:** 08/21/2015