Organization
ENDOSCOPY CENTER OF MONROE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDY WALDO (ADMINISTRATOR)
(318) 327-3105
Entity
Organization
Contact information
Practice address
316 S 6TH ST, MONROE, LA 71201-7568
(318) 327-3107
(318) 327-3110
Mailing address
316 S 6TH ST, MONROE, LA 71201-7568
(318) 327-3107
(318) 327-3110
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
261QE0800X
Endoscopy Clinic/Center
38
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1385735
—
LA
01
—
2059C
BLUE CROSS OF LOUISIANA
—
01
—
P2590
RAILROAD MEDICARE
—
Enumeration date
07/28/2005
Last updated
01/10/2025
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