Organization
URBAN MEDICAL CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KERMIT LAMAR WALTERS JR. M.D. (PRESIDENT)
(318) 325-7998
Entity
Organization
Contact information
Practice address
1910 JACKSON ST., MONROE, LA 71202-2532
(318) 325-7998
(318) 398-0888
Mailing address
1910 JACKSON ST., MONROE, LA 71202-2532
(318) 325-7998
(318) 398-0888
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1797715
—
LA
Enumeration date
09/13/2012
Last updated
09/13/2012
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