Healthcare Provider Details

I. General information

NPI: 1164442885
Provider Name (Legal Business Name): ELIZABETH M. CAIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51704 HIGHWAY 438
FRANKLINTON LA
70438-7488
US

IV. Provider business mailing address

PO BOX 430
AMITE LA
70422-0430
US

V. Phone/Fax

Practice location:
  • Phone: 985-848-9955
  • Fax: 985-730-7183
Mailing address:
  • Phone: 985-748-8917
  • Fax: 985-730-7183

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number021218
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: