# MEDICAL ASSOCIATION OF NORTHEAST LOUISIANA INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023185220
- **Authorized official:** ASSAD HUSEIN MOUHAFFEL M.D. (OWNER)
- **Authorized official phone:** (318) 387-1946

## Contact information

- **Practice address:** 102 THOMAS RD, SUITE 103, WEST MONROE, LA 71291-7365
- **Practice address phone:** (318) 387-1946
- **Practice address fax:** (318) 387-8781
- **Mailing address:** 102 THOMAS RD, SUITE 103, WEST MONROE, LA 71291-7366
- **Mailing address phone:** (318) 387-1946
- **Mailing address fax:** (318) 387-8781

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 12175R | LA | Yes |

## Other

- **Enumeration date:** 11/30/2006
- **Last updated:** 01/09/2012