# LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LSU Clinics of Monroe
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962674713
- **Authorized official:** MRS. MELANIE H SOTAK MHSA (DIRECTOR OF MANAGED CARE)
- **Authorized official phone:** (318) 675-7737

## Contact information

- **Practice address:** 4864 JACKSON ST, MONROE, LA 71202-6400
- **Practice address phone:** (318) 330-7000
- **Practice address fax:** (318) 675-5666
- **Mailing address:** 1501 KINGS HWY, SHARED BILLING SERVICES, SHREVEPORT, LA 71103-4228
- **Mailing address phone:** (318) 675-5000
- **Mailing address fax:** (318) 675-5666

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207P00000X | Emergency Medicine Physician | 142 | LA | — |
| 207Q00000X | Family Medicine Physician | 142 | LA | Yes |
| 207R00000X | Internal Medicine Physician | 142 | LA | — |
| 207V00000X | Obstetrics & Gynecology Physician | 142 | LA | — |
| 207W00000X | Ophthalmology Physician | 142 | LA | — |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | 142 | LA | — |
| 208000000X | Pediatrics Physician | 142 | LA | — |

## Other

- **Enumeration date:** 04/01/2008
- **Last updated:** 04/01/2008