Organization
NORTHEAST LOUISIANA CARDIOVASCULAR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY C SAMPOGNARO M.D. (PRESIDENT)
(318) 322-7726
Entity
Organization
Contact information
Practice address
2503 BROADMOOR BLVD, MONROE, LA 71201-2987
(318) 322-7726
(318) 322-2614
Mailing address
2503 BROADMOOR BLVD, MONROE, LA 71201-2987
(318) 322-7726
(318) 322-2614
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4388289030
BLUE CROSS
LA
Enumeration date
10/03/2006
Last updated
02/23/2012
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