Provider Demographics
NPI:1730383803
Name:ONCOLOGY ASSOCIATES OF MONROE
Entity type:Organization
Organization Name:ONCOLOGY ASSOCIATES OF MONROE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:KIESHA
Authorized Official - Middle Name:D
Authorized Official - Last Name:YATES
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:318-325-7007
Mailing Address - Street 1:PO BOX 6137
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71211-6137
Mailing Address - Country:US
Mailing Address - Phone:318-325-7007
Mailing Address - Fax:318-699-0025
Practice Address - Street 1:411 CALYPSO ST
Practice Address - Street 2:SUITE 200
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-7506
Practice Address - Country:US
Practice Address - Phone:318-325-7007
Practice Address - Fax:318-699-0025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty