Individual
DR. RUSSELL T LOLLEY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
102 THOMAS RD., STE 201, WEST MONROE, LA 71291-5547
(318) 329-8411
(318) 329-8412
Mailing address
102 THOMAS RD., STE 203, WEST MONROE, LA 71291-5547
(318) 387-1811
(318) 387-7529
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
010612
LA
208600000X
Surgery Physician
Primary
MD.010612
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1136361
—
LA
Enumeration date
06/26/2006
Last updated
05/08/2023
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