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Organization

SOUTHERN ENDOCRINOLOGY CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MOHAMMAD MOUSA M.D. (OWNER)
(318) 398-9580
Entity
Organization

Contact information

Practice address
3418 MEDICAL PARK DR, SUITE 23, MONROE, LA 71203-2376
(318) 398-9580
Mailing address
PO BOX 4766, MONROE, LA 71211-4766
(318) 398-9580

Taxonomy

Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
12099R
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1696595
LA
Enumeration date
09/30/2006
Last updated
08/22/2020
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