Provider Demographics
NPI:1174633721
Name:MONROE-WILKES, GRETA (MD)
Entity Type:Individual
Prefix:DR
First Name:GRETA
Middle Name:
Last Name:MONROE-WILKES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10174
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70813-2021
Mailing Address - Country:US
Mailing Address - Phone:225-771-4770
Mailing Address - Fax:225-771-6225
Practice Address - Street 1:8770 ELTON C HARRISON DRIVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70813-4033
Practice Address - Country:US
Practice Address - Phone:225-771-4770
Practice Address - Fax:225-771-6225
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10307R207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA080180810OtherRAILROAD MEDICARE
LA1532274Medicaid
LA080180810OtherRAILROAD MEDICARE
LA1532274Medicaid