# MONROE HMA PHYSICIAN MANAGEMENT LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MONROE HMA PHYSICIAN MANAGEMENT LLC
- **Other names:** Loganville OB/GYN
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1073753299
- **Legal business name:** MONROE HMA PHYSICIAN MANAGEMENT LLC
- **Authorized official:** JENNIFER VIRGILIO (PRACTICE MANAGER)
- **Authorized official phone:** (770) 207-7859

## Contact information

- **Practice address:** 3543 HIGHWAY 81, LOGANVILLE, GA 30052-4336
- **Practice address phone:** (770) 913-8082
- **Practice address fax:** (770) 913-8085
- **Mailing address:** 705 BREEDLOVE DR, SUITE 200, MONROE, GA 30655-2090
- **Mailing address phone:** (770) 266-0351
- **Mailing address fax:** (770) 266-0313

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 051832 | GA | Yes |

## Other

- **Enumeration date:** 02/27/2009
- **Last updated:** 03/05/2009