| Southern Endocrinology Llc | |
|
102 Thomas Rd Ste 113 West Monroe LA 71291-7365 | |
| (318) 387-3453 | |
| Not Available |
| Full Name | Southern Endocrinology Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 102 Thomas Rd Ste 113, West Monroe, Louisiana |
| Authorized Official Name and Position | Mohammad Mousa (PHYSICIAN/OWNER) |
| Authorized Official Contact | 3183873453 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Endocrinology Llc 2026 Rosedown Dr Monroe LA 71201-3083 Ph: () - | Southern Endocrinology Llc 102 Thomas Rd Ste 113 West Monroe LA 71291-7365 Ph: (318) 387-3453 |
| NPI Number | 1316413560 |
|---|---|
| Provider Enumeration Date | 10/15/2018 |
| Last Update Date | 10/15/2018 |
| Medicare PECOS PAC ID | 5395080212 |
|---|---|
| Medicare Enrollment ID | O20181221000867 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316413560 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
| Provider Name | Mohammad Mousa |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1841383221 PECOS PAC ID: 4183682743 Enrollment ID: I20050107000004 |
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