Provider Demographics
NPI:1184806374
Name:ROLF D. MORSTEAD, M.D. APMC
Entity type:Organization
Organization Name:ROLF D. MORSTEAD, M.D. APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROLF
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:MORSTEAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-324-0055
Mailing Address - Street 1:312 GRAMMONT ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-7457
Mailing Address - Country:US
Mailing Address - Phone:318-324-0055
Mailing Address - Fax:318-324-9959
Practice Address - Street 1:312 GRAMMONT ST
Practice Address - Street 2:SUITE 301
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-7457
Practice Address - Country:US
Practice Address - Phone:318-324-0055
Practice Address - Fax:318-324-9959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-29
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD022706208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1492221Medicaid
LA1492221Medicaid
LA5H366CD77Medicare PIN