Organization
WEST MONROE FAMILY PRACTICE CLINIC
Active
Parent organization
ONE SOURCE MEDICAL MANAGEMENT, INC.
Other names
Family Practice Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
ONE SOURCE MEDICAL MANAGEMENT, INC.
Authorized official
DANNY GARNER (PRACTICE MANAGER)
(318) 398-2680
Entity
Organization
Contact information
Practice address
2933 CYPRESS ST STE 1, HALL A, WEST MONROE, LA 71291-5337
(318) 398-2680
(318) 322-2885
Mailing address
PO BOX 2673, WEST MONROE, LA 71294-2673
(318) 398-2680
(318) 322-2885
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2356232
—
LA
Enumeration date
01/28/2014
Last updated
04/26/2016
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