Organization
AFFINITY HEALTH GROUP, LLC
Active
Other names
Affinity Central Lab
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE BREARD (EXECUTIVE VICE PRESIDENT)
(318) 361-0900
Entity
Organization
Contact information
Practice address
920 OLIVER RD, SUITE C, MONROE, LA 71201-5702
(318) 812-7050
(318) 812-7053
Mailing address
130 DESIARD ST, SUITE 355, MONROE, LA 71201-7319
(318) 807-7875
(318) 812-6603
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
208000000X
Pediatrics Physician
—
—
2084P0800X
Psychiatry Physician
—
—
208600000X
Surgery Physician
—
—
208800000X
Urology Physician
—
—
208D00000X
General Practice Physician
—
—
Other
Enumeration date
06/12/2015
Last updated
08/21/2015
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