Urology Clinic of Northeast Louisiana - a Medical Corporation

NPI #1760418396 in Monroe, Louisiana

Provider Information

NPI Number: 1760418396
Entity Type: Organization
Organization Name: Urology Clinic of Northeast Louisiana - a Medical Corporation
Primary Specialty: Urology
Enumeration Date: Jun 24, 2006
Last Updated: Oct 19, 2012

Practice Location

Address: 711 SAINT JOHN STREET
City: Monroe
State: Louisiana
ZIP Code: 71201-8435
Phone: (318) 387-9420

Authorized Official

Name: JON BRADLEY JOHNSON, MD
Title: PHYSICIAN OWNER
Phone: (318) 387-9420

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Urology	208800000X	Primary

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