Organization
AFFINITY HEALTH GROUP, LLC
Active
Other names
THE MEDICAL OFFICE
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIKE BREARD (VICE PRESIDENT)
(318) 361-0900
Entity
Organization
Contact information
Practice address
112 SAINT JOHN ST, MONROE, LA 71201-7322
(318) 387-5681
(318) 322-9957
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
MD016846
LA
363LF0000X
Family Nurse Practitioner
AP04747
LA
Other
Enumeration date
11/30/2006
Last updated
07/05/2011
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