Provider Demographics
NPI:1821171497
Name:WOMEN'S HEALTH ASSOCIATES OF MONROE
Entity Type:Organization
Organization Name:WOMEN'S HEALTH ASSOCIATES OF MONROE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:WHITNEY
Authorized Official - Last Name:MERCER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:318-325-1731
Mailing Address - Street 1:410 WOOD STREET
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201
Mailing Address - Country:US
Mailing Address - Phone:318-325-1731
Mailing Address - Fax:318-325-5636
Practice Address - Street 1:410 WOOD ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-7445
Practice Address - Country:US
Practice Address - Phone:318-325-1731
Practice Address - Fax:318-325-5636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAL023779207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1487163Medicaid
LA5H553CM05Medicare ID - Type Unspecified
H22305Medicare UPIN