Individual
GWENDOLYN HOLDINESS PROCTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1825 N 18TH ST, SUITE A, MONROE, LA 71201-4420
(318) 807-3700
(318) 807-0014
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
204506
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05818
—
LA
Enumeration date
05/15/2008
Last updated
09/07/2011
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