Organization
MEDICAL ASSOCIATION OF NORTHEAST LOUISIANA INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASSAD HUSEIN MOUHAFFEL M.D. (OWNER)
(318) 387-1946
Entity
Organization
Contact information
Practice address
102 THOMAS RD, SUITE 103, WEST MONROE, LA 71291-7365
(318) 387-1946
(318) 387-8781
Mailing address
102 THOMAS RD, SUITE 103, WEST MONROE, LA 71291-7366
(318) 387-1946
(318) 387-8781
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
12175R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1448508
—
LA
Enumeration date
11/30/2006
Last updated
01/09/2012
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