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Organization
AFFINITY HEALTH GROUP, LLC
Active
Organization
AFFINITY HEALTH GROUP, LLC
Active
Other names
THE MEDICAL OFFICE
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIKE BREARD (VICE PRESIDENT)
(318) 361-0900
Entity
Organization
Contact information
Practice address
112 SAINT JOHN ST, MONROE, LA 71201-7322
(318) 387-5681
(318) 322-9957
Mailing address
130 DESIARD ST, STE 355, MONROE, LA 71201-7319
(318) 807-7875
(318) 812-9997
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD016846
LA
363LF0000X
Family Nurse Practitioner
AP04747
LA
Other
Enumeration date
11/30/2006
Last updated
07/05/2011
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