Basic Information
| Provider Information | |||||||||
| NPI: | 1073545307 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HOSPITALIST GROUP OF NORTHEAST LOUISIANA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 503 MCMILLAN RD | ||||||||
| Address2: | |||||||||
| City: | WEST MONROE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 712915327 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3183294744 | ||||||||
| FaxNumber: | 3183294719 | ||||||||
| Practice Location | |||||||||
| Address1: | 503 MCMILLAN RD | ||||||||
| Address2: | |||||||||
| City: | WEST MONROE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 712915327 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3183294744 | ||||||||
| FaxNumber: | 3183294719 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2006 | ||||||||
| LastUpdateDate: | 09/18/2013 | ||||||||
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| AuthorizedOfficialLastName: | ALEXANDER | ||||||||
| AuthorizedOfficialFirstName: | WILLIAM | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 3183888124 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 1447455 | 05 | LA | MEDICAID |