Organization
UNIVERSITY OF LOUISIANA MONROE
Active
Other names
ULM
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN RAYMOND WOOTEN JR. PHD (PROGRAM DIRECTOR)
(318) 361-3003
Entity
Organization
Contact information
Practice address
4604 LINCOLN PARK AVE, MONROE, LA 71202-5919
(318) 324-9450
(318) 324-9450
Mailing address
4606 LINCLON PRK AVE, MONROE, LA 71201-5919
(318) 324-9450
(318) 324-9450
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
120530
LA
Other
Enumeration date
05/15/2007
Last updated
08/22/2020
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