# PHYSICIAN GROUP OF LOUISIANA INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** STEWARD MEDICAL GROUP OF LOUISIANA
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013486059
- **Authorized official:** JONATHAN A DEMKE (CEO)
- **Authorized official phone:** (615) 467-1072

## Contact information

- **Practice address:** 1900 N 7TH ST, WEST MONROE, LA 71291-4416
- **Practice address phone:** (318) 651-7000
- **Mailing address:** PO BOX 281796, ATLANTA, GA 30384-1796
- **Mailing address phone:** (866) 243-7107
- **Mailing address fax:** (314) 432-9683

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/20/2018
- **Last updated:** 11/20/2018