Healthcare Provider Details

I. General information

NPI: 1457149262
Provider Name (Legal Business Name): ELENA MILSTEAD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2025
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1585 3RD ST
FORT POLK LA
71459-5102
US

IV. Provider business mailing address

1585 3RD ST
FORT POLK LA
71459-5102
US

V. Phone/Fax

Practice location:
  • Phone: 580-215-9613
  • Fax:
Mailing address:
  • Phone: 580-215-9613
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: