Healthcare Provider Details

I. General information

NPI: 1609093384
Provider Name (Legal Business Name): RICHARD LOUIS MCELVEEN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2007
Last Update Date: 10/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10002 GULF HWY
LAKE CHARLES LA
70607-8672
US

IV. Provider business mailing address

PO BOX 878
LAKE CHARLES LA
70602-0878
US

V. Phone/Fax

Practice location:
  • Phone: 337-912-1825
  • Fax:
Mailing address:
  • Phone: 337-721-1961
  • Fax: 337-721-1939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number1436
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number1436
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code111NR0200X
TaxonomyRadiology Chiropractor
License Number1436
License Number StateLA
# 4
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number1436
License Number StateLA
# 5
Primary TaxonomyN
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number1436
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: