Organization
LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER
Active
Other names
LSU Clinics of Monroe
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MELANIE H SOTAK MHSA (DIRECTOR OF MANAGED CARE)
(318) 675-7737
Entity
Organization
Contact information
Practice address
4864 JACKSON ST, MONROE, LA 71202-6400
(318) 330-7000
(318) 675-5666
Mailing address
1501 KINGS HWY, SHARED BILLING SERVICES, SHREVEPORT, LA 71103-4228
(318) 675-5000
(318) 675-5666
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
142
LA
207Q00000X
Family Medicine Physician
Primary
142
LA
207R00000X
Internal Medicine Physician
142
LA
207V00000X
Obstetrics & Gynecology Physician
142
LA
207W00000X
Ophthalmology Physician
142
LA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
142
LA
208000000X
Pediatrics Physician
142
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1792896
—
LA
Enumeration date
04/01/2008
Last updated
04/01/2008
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