Individual
JOSEPH ROGER FANDAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1501 LOUISVILLE AVE, MONROE, LA 71201-6025
(318) 323-8451
(318) 361-2613
Mailing address
1501 LOUISVILLE AVE, MONROE, LA 71201-6025
(318) 323-8451
(318) 361-2613
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
LA
Other
Enumeration date
08/21/2015
Last updated
08/21/2015
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