Healthcare Provider Details

I. General information

NPI: 1790745073
Provider Name (Legal Business Name): JOSEPH DANIEL ELFERT JR. MD LLC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 WRIGHT AVE STE F
CROWLEY LA
70526
US

IV. Provider business mailing address

1325 WRIGHT AVE STE F
CROWLEY LA
70526
US

V. Phone/Fax

Practice location:
  • Phone: 337-783-2915
  • Fax: 337-783-2704
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number013779
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: