NPI 1538375753

University of Louisiana Monroe

Organisation Health Maintenance Organization Monroe, LA

Practice location

Address: 4604 Lincoln Park Ave, Monroe, LA 71202-5919
Phone: (318) 324-9450
Fax: (318) 324-9450
Mailing address: 4606 Linclon Prk Ave, Monroe, LA 71201-5919

Authorised official

Name: John Raymond Wooten
Title: Program Director
Phone: (318) 361-3003

Registered specialties

Health Maintenance Organization Primary

Managed Care Organizations Taxonomy 302R00000X Licence 120530 (LA)

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Registry record

NPI: 1538375753
Entity type: Organization
NPI issued: 15 May 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.