Provider Demographics
NPI:1598754699
Name:SFMC HOSPITALIST
Entity Type:Organization
Organization Name:SFMC HOSPITALIST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO/SR VP
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:HOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-327-7369
Mailing Address - Street 1:PO BOX 3249
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71210-3249
Mailing Address - Country:US
Mailing Address - Phone:318-327-4540
Mailing Address - Fax:
Practice Address - Street 1:309 JACKSON ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-7407
Practice Address - Country:US
Practice Address - Phone:318-327-4540
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST FRANCIS MEDICAL CENTER, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-10-20
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA157208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1447684Medicaid
LA1447684Medicaid