# 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:** 1932662616
- **Authorized official:** JONATHAN A DEMKE (CEO)
- **Authorized official phone:** (615) 467-1072

## Contact information

- **Practice address:** 503 MCMILLAN RD, WEST MONROE, LA 71291-5327
- **Practice address phone:** (318) 329-4200
- **Practice address fax:** (318) 329-4710
- **Mailing address:** PO BOX 24573, BELFAST, ME 04915-4496
- **Mailing address phone:** (855) 660-0300

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/10/2019
- **Last updated:** 04/10/2019