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Organization
AFFINITY HEALTH GROUP, LLC
Active
Organization
AFFINITY HEALTH GROUP, LLC
Active
Other names
THE MEDICAL OFFICE NORTH
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIKE BREARD (VICE PRESIDENT)
(318) 361-0900
Entity
Organization
Contact information
Practice address
3400 MEDICAL PARK DR, STE B, MONROE, LA 71203-2388
(318) 387-6803
(318) 387-6874
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
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
06/16/2011
Last updated
07/05/2011
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